Healthcare Provider Details

I. General information

NPI: 1881539955
Provider Name (Legal Business Name): MERIDIAN HEALTH MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2219 PESTALOZZI ST APT C
SAINT LOUIS MO
63118-1673
US

IV. Provider business mailing address

2219 PESTALOZZI ST APT C
SAINT LOUIS MO
63118-1673
US

V. Phone/Fax

Practice location:
  • Phone: 812-553-4235
  • Fax:
Mailing address:
  • Phone: 812-553-4235
  • 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: MOHAMED EBBOU
Title or Position: OWNER
Credential:
Phone: 812-553-4235