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Organization

STATEWIDE MEDITRANS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA DOFFLEMYER (OWNER)
(541) 813-9006
Entity
Organization

Contact information

Practice address
515 HASSETT ST, BROOKINGS, OR 97415-8205
(541) 813-9006
Mailing address
515 HASSETT ST, BROOKINGS, OR 97415-8205
(541) 813-9006

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
93287291
OR

Other

Enumeration date
04/24/2013
Last updated
04/24/2013
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