Provider Demographics
NPI:1912881012
Name:DEDICATED NEMT INC.
Entity type:Organization
Organization Name:DEDICATED NEMT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURITZEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-419-2100
Mailing Address - Street 1:1919 WILLIAMS ST STE 310
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-7842
Mailing Address - Country:US
Mailing Address - Phone:818-419-2100
Mailing Address - Fax:
Practice Address - Street 1:1919 WILLIAMS ST STE 310
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-7842
Practice Address - Country:US
Practice Address - Phone:818-419-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)