Healthcare Provider Details
I. General information
NPI: 1013848563
Provider Name (Legal Business Name): A1 MED TRANSPO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
813 ANTLER DR APT B
MIDDLEBURY IN
46540-9444
US
IV. Provider business mailing address
813 ANTLER DR APT B
MIDDLEBURY IN
46540-9444
US
V. Phone/Fax
- Phone: 574-606-3852
- Fax:
- Phone: 574-606-3852
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JONATHAN
AGUIRRE
Title or Position: MANAGER
Credential:
Phone: 574-606-3852