Healthcare Provider Details

I. General information

NPI: 1477428449
Provider Name (Legal Business Name): 380 TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 JAMES WAY APT 201
MARION OH
43302-7831
US

IV. Provider business mailing address

380 JAMES WAY APT 201
MARION OH
43302-7831
US

V. Phone/Fax

Practice location:
  • Phone: 220-257-8987
  • Fax:
Mailing address:
  • Phone: 220-257-8987
  • 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: MALEK ALDUMMAN
Title or Position: OWNER
Credential:
Phone: 220-257-8987