Healthcare Provider Details

I. General information

NPI: 1043137573
Provider Name (Legal Business Name): HARBOR MEDICAL MOBILITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 E ROUNDTABLE DR
CANTON MI
48188-1926
US

IV. Provider business mailing address

2145 E ROUNDTABLE DR
CANTON MI
48188-1926
US

V. Phone/Fax

Practice location:
  • Phone: 734-740-3940
  • Fax:
Mailing address:
  • Phone: 734-740-3940
  • 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: NICKOLAS MICHAEL ADAMCZYK
Title or Position: CEO
Credential:
Phone: 734-740-3940