1669414124 NPI number — HEALTHLINK MEDICAL TRANSPORTATION SERVICES INC

Table of content: (NPI 1669414124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669414124 NPI number — HEALTHLINK MEDICAL TRANSPORTATION SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHLINK MEDICAL TRANSPORTATION SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669414124
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26150 NORTHLINE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAYLOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48180-6511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-946-2407
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26187 NORTHLINE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAYLOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48180-4412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-946-2407
Provider Business Practice Location Address Fax Number:
734-946-0405
Provider Enumeration Date:
06/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BEAUCHEMIN
Authorized Official First Name:
GREG
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
248-356-3900

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  821074 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3385044 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".