Medical Transport Management, Inc
Organization Active NPI Land Ambulance · Dermott, AR
NPI 1780119610 · NPPES record last updated Apr 28, 2017
Key facts
- NPI
- 1780119610
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 0470 (AR)
- Legal business name
- MEDICAL TRANSPORT MANAGEMENT, INC
- Practice address
- 109 W Peddicord St
Dermott, AR 71638-2115 - Phone
- (870) 538-3900
- Fax
- (870) 538-3902
- NPI assigned
- Apr 28, 2017
- Organization subpart
- No
Authorized official
- Name
- Jim L Dintelman, EMT
- Title
- Ceo/Owner
- Phone
- (870) 538-3900
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170720001344 | AR | Part B Supplier - Ambulance Service Supplier | 2668742834 | Practice locations: Dermott, AR |
National Provider Directory
Locations
109 W Peddicord St
Dermott, AR 71638
Phone (870) 538-3900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 0470 | AR | Yes |
Addresses
Primary practice location
109 W Peddicord St
Dermott, AR 71638-2115
Mailing address
109 W Peddicord St
Dermott, AR 71638-2115
Phone (870) 538-3900
Other providers in Dermott, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.