MEDICARE: ACTION MOBILITY TRANSPORT

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	172A00000X	Driver

General Provider Information

NPI Number	:	1760311054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTION MOBILITY TRANSPORT

Provider Business Mailing Address
First Line	:	22 DUTCHESS CT
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-1727
Country	:	US
Telephone Number	:	240-653-6862
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 DUTCHESS CT
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-1727
Country	:	US
Telephone Number	:	240-653-6862
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARIAMA KOROMA
Credential	:
Telephone Number	:	240-653-6862

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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Directions to “ACTION MOBILITY TRANSPORT ” Practice Location

Language	Start Address	Practice Location

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