Healthcare Provider Details
I. General information
NPI: 1104674308
Provider Name (Legal Business Name): MEDI-GO MEDICAL TRANSPORTATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2024
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5883 STRAWMOUNT TRL
CHITTENANGO NY
13037-4001
US
IV. Provider business mailing address
418 BROADWAY STE R
ALBANY NY
12207-2922
US
V. Phone/Fax
- Phone: 732-947-2533
- Fax:
- Phone: 732-947-2533
- 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 | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 344600000X |
| Taxonomy | Taxi |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347E00000X |
| Taxonomy | Transportation Broker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
REHAB
ELDAW
TAHA
Title or Position: OWNER/ MEMBER
Credential:
Phone: 732-947-2533