Healthcare Provider Details

I. General information

NPI: 1285009241
Provider Name (Legal Business Name): MD TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2015
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13126 PENNSYLVANIA AVE 103
HAGERSTOWN MD
21742-2755
US

IV. Provider business mailing address

13126 PENNSYLVANIA AVE 103
HAGERSTOWN MD
21742-2755
US

V. Phone/Fax

Practice location:
  • Phone: 240-586-1352
  • Fax:
Mailing address:
  • Phone: 240-586-1352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW D MCKEEL
Title or Position: OWNER
Credential:
Phone: 240-586-1352