Statewide Meditrans

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

93287291 Issued in OR

Legal business name

STATEWIDE MEDITRANS

Practice address

515 Hassett St
Brookings, OR 97415-8205

Phone

(541) 813-9006

NPI assigned

Apr 24, 2013

Last updated

Apr 24, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa Dofflemyer

Title

Owner

Phone

(541) 813-9006

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366761600000",
    "number": "1134563893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 HASSETT ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974158205",
            "telephone_number": "541-813-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 HASSETT ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974158205",
            "telephone_number": "541-813-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEWIDE MEDITRANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-04-24",
        "status": "A",
        "authorized_official_last_name": "DOFFLEMYER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-813-9006"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "OR",
            "license": "93287291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Brookings, OR
• Providers in Brookings, OR by specialty
• Non-emergency Medical Transport (VAN) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.