Healthcare Provider Details

I. General information

NPI: 1205759297
Provider Name (Legal Business Name): UD MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 PICKERINGTON PONDS DR
PICKERINGTON OH
43147-7738
US

IV. Provider business mailing address

188 PICKERINGTON PONDS DR
PICKERINGTON OH
43147-7738
US

V. Phone/Fax

Practice location:
  • Phone: 614-556-7220
  • Fax:
Mailing address:
  • Phone: 614-556-7220
  • 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 Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL GOBA
Title or Position: OWNER
Credential: BSN
Phone: 614-556-7220