MEDICAL TRANSPORT MANAGEMENT, INC (NPI# 1780119610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780119610 |
| Entity Type | Organization |
| Organization Name | MEDICAL TRANSPORT MANAGEMENT, INC |
| Practice Address |
109 W Peddicord St Dermott AR 71638-2115 |
| Practice Telephone | 8705383900 |
| Practice Fax Number | 8705383902 |
| Mailing Telephone | 8705383900 |
| Mailing Fax Number | 8705383902 |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2017-04-28 |
| Authorized Official Name | JIM L DINTELMAN (CEO/OWNER) |
| Authorized Official Telephone | 8705383900 |
| Authorized Official Credential | EMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
0470 | AR | Transportation Services |
| Street Address |
109 W PEDDICORD ST |
| City | DERMOTT |
| State | AR |
| Zip Code | 71638-2115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104251180 | Rebekah Ayecock | Nurse Practitioner | 300 South School St, Dermott, AR 71638 | 2013-09-09 |
| 1508198201 | Roger Alan Mason | Surgery | 300 South School St., Dermott, AR 71638 | 2010-02-04 |
| 1730219353 | Dermott Day Service Center, Inc. | Day Training, Developmentally Disabled Services | 817 North School Street, Dermott, AR 71638 | 2007-03-06 |
| 1134286750 | Dermott City Nursing Home | Skilled Nursing Facility | 702 West Gaines St., Dermott, AR 71638 | 2007-01-02 |
| 1861555005 | Dermott High School | Local Education Agency (LEA) | 525 East Speedway, Dermott, AR 71638 | 2006-12-19 |
| 1811095656 | Phillip W Pennington | Dentist | 300 S School, Dermott, AR 71638 | 2006-09-20 |
| 1669401501 | Mainline Health Systems, Inc | Clinic/Center | 134 South Strickland St, Dermott, AR 71638 | 2006-07-02 |
| 1982643409 | Jeffery Fenton Dunn Sr. | Pharmacist | 111 E Peddicord Street, Dermott, AR 71638 | 2006-06-06 |
| 1609298306 | Cb King Jm | Day Training, Developmentally Disabled Services | 1109 North School, Dermott, AR 71638-0000 | 2014-01-15 |
| 1902191596 | Medical Transport Management, LLC | Ambulance | 111 W Peddicord St, Dermott, AR 71638-2115 | 2011-06-13 |
| Find all providers in zip 71638 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902191596 | Medical Transport Management, LLC | Ambulance | 111 W Peddicord St, Dermott, AR 71638-2115 | 2011-06-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.