MEDICARE: MOBILE MEDICAL TECHNICIANS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	246RP1900X	Phlebotomy Technician
2	2472E0500X	EEG Technician
3	343900000X	Non-emergency Medical Transport (VAN)
4	374U00000X	Home Health Aide
5	332U00000X	Home Delivered Meals

General Provider Information

NPI Number	:	1568097459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE MEDICAL TECHNICIANS LLC

Provider Business Mailing Address
First Line	:	2329 W GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48208-1205
Country	:	US
Telephone Number	:	313-657-4610
Fax Number	:

Provider Business Practice Location Address
First Line	:	2329 W GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48208-1205
Country	:	US
Telephone Number	:	313-657-4610
Fax Number	:

Authorized Official
Title or Position	:	ADMINSTRATOR
Name	:	MARKEA JENKINS
Credential	:
Telephone Number	:	313-657-4610

Provider Enumeration Date	:	03/11/2020
Last Update Date	:	08/14/2025

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