Healthcare Provider Details

I. General information

NPI: 1710824909
Provider Name (Legal Business Name): MIDWEST OPTIMAL TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 WOOD ST
PARK HILLS MO
63601-4526
US

IV. Provider business mailing address

22 WOOD ST
PARK HILLS MO
63601-4526
US

V. Phone/Fax

Practice location:
  • Phone: 573-952-0994
  • Fax:
Mailing address:
  • Phone: 573-952-0994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER MICHELLE HIERRO
Title or Position: OWNER
Credential: HIERRO
Phone: 573-952-0994