Healthcare Provider Details

I. General information

NPI: 1922934694
Provider Name (Legal Business Name): MIRACLE TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 DENISE CIR
EIGHT MILE AL
36613-9542
US

IV. Provider business mailing address

8540 DENISE CIR
EIGHT MILE AL
36613-9542
US

V. Phone/Fax

Practice location:
  • Phone: 251-656-9913
  • Fax:
Mailing address:
  • Phone: 251-656-9913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATRINA SHEARLS DAVIS
Title or Position: OWNER OPERATOR
Credential:
Phone: 251-656-9913