Healthcare Provider Details

I. General information

NPI: 1467026708
Provider Name (Legal Business Name): MBD TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3906 TURNBRIDGE CT UNIT 311
BRUNSWICK OH
44212-3093
US

IV. Provider business mailing address

3906 TURNBRIDGE CT UNIT 311
BRUNSWICK OH
44212-3093
US

V. Phone/Fax

Practice location:
  • Phone: 440-855-4703
  • Fax:
Mailing address:
  • Phone: 216-801-5639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: MR. TREVOR WRIGHT
Title or Position: OPERATION MANAGER
Credential:
Phone: 513-449-0777