MEDICARE: MODERN TRANSPORTATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347E00000X	Transportation Broker

General Provider Information

NPI Number	:	1285105924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MODERN TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	4352 15 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-5409
Country	:	US
Telephone Number	:	586-728-0069
Fax Number	:

Provider Business Practice Location Address
First Line	:	4352 15 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-5409
Country	:	US
Telephone Number	:	586-728-0069
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IBRAHIM ORFALI
Credential	:
Telephone Number	:	586-354-3654

Provider Enumeration Date	:	12/06/2018
Last Update Date	:	12/06/2018

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Directions to “MODERN TRANSPORTATION LLC ” Practice Location

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