Healthcare Provider Details
I. General information
NPI: 1770411191
Provider Name (Legal Business Name): MICHIGAN MEDIRIDES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/13/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
36273 MAAS DR
STERLING HEIGHTS MI
48312-2828
US
IV. Provider business mailing address
36273 MAAS DR
STERLING HEIGHTS MI
48312-2828
US
V. Phone/Fax
- Phone: 586-224-2339
- Fax:
- Phone: 586-224-2339
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JASMINA
KLJAJIC
Title or Position: OWNER
Credential:
Phone: 586-224-2339