Healthcare Provider Details

I. General information

NPI: 1962335166
Provider Name (Legal Business Name): MEDWAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 N LYCEE ST APT 233
BEL AIRE KS
67226-8728
US

IV. Provider business mailing address

5700 N LYCEE ST APT 233
BEL AIRE KS
67226-8728
US

V. Phone/Fax

Practice location:
  • Phone: 620-617-3473
  • Fax:
Mailing address:
  • Phone: 620-617-3473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED MOHAMED
Title or Position: OWNER
Credential: MOHAMED
Phone: 620-617-3473