Healthcare Provider Details

I. General information

NPI: 1619717543
Provider Name (Legal Business Name): SADIE MAE'S TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 05/29/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12841 SARASOTA
REDFORD MI
48239-2656
US

IV. Provider business mailing address

12841 SARASOTA
REDFORD MI
48239-2656
US

V. Phone/Fax

Practice location:
  • Phone: 734-519-6691
  • Fax:
Mailing address:
  • Phone: 734-519-6691
  • 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: CYNTHIA BOND
Title or Position: PRESIDENT
Credential:
Phone: 419-516-6966