Provider Demographics
NPI:1053932772
Name:N.E.M.T BY MOE LLC
Entity type:Organization
Organization Name:N.E.M.T BY MOE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:PATRISE
Authorized Official - Last Name:MURRAY CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-260-8909
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:30724 BENTON RD STE C302
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8470
Mailing Address - Country:US
Mailing Address - Phone:951-260-8909
Mailing Address - Fax:
Practice Address - Street 1:39195 ETERNITY LN
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-6873
Practice Address - Country:US
Practice Address - Phone:951-260-8909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2023-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No305S00000XManaged Care OrganizationsPoint of Service
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1396286787Medicaid
CA1053932772Medicaid