Healthcare Provider Details

I. General information

NPI: 1710596515
Provider Name (Legal Business Name): UNITED HEARTS TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45487 PENTWATER DR
MACOMB MI
48044-4236
US

IV. Provider business mailing address

45487 PENTWATER DR
MACOMB MI
48044-4236
US

V. Phone/Fax

Practice location:
  • Phone: 586-745-1333
  • Fax: 586-329-1117
Mailing address:
  • Phone: 586-745-1333
  • Fax: 586-329-1117

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: ABOUBACRY BA
Title or Position: OWNER
Credential:
Phone: 586-745-1333