Provider Demographics
NPI:1366981730
Name:ADVANCE MEDICAL TRANSPORTERS
Entity type:Organization
Organization Name:ADVANCE MEDICAL TRANSPORTERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:TRIANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-210-9278
Mailing Address - Street 1:2409 N RUTGERS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-2200
Mailing Address - Country:US
Mailing Address - Phone:316-210-9278
Mailing Address - Fax:316-226-9136
Practice Address - Street 1:2409 N RUTGERS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-2200
Practice Address - Country:US
Practice Address - Phone:316-210-9278
Practice Address - Fax:316-226-9136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-18
Last Update Date:2017-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)