Healthcare Provider Details

I. General information

NPI: 1538953740
Provider Name (Legal Business Name): EBENEZER TRANSPORTATION UNLIMITED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3744 FINNEY AVE
SAINT LOUIS MO
63113-3904
US

IV. Provider business mailing address

3744 FINNEY AVE
SAINT LOUIS MO
63113-3904
US

V. Phone/Fax

Practice location:
  • Phone: 314-601-5561
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: ELIAS MUHAMA
Title or Position: CEO
Credential:
Phone: 314-601-5561