Healthcare Provider Details

I. General information

NPI: 1497598361
Provider Name (Legal Business Name): IN DRIVE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4535 MCKAIN DR
TOLEDO OH
43623-3835
US

IV. Provider business mailing address

4535 MCKAIN DR
TOLEDO OH
43623-3835
US

V. Phone/Fax

Practice location:
  • Phone: 419-297-0637
  • Fax:
Mailing address:
  • Phone: 419-297-0637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: SHEHATA MOHAMED MAHMOUD
Title or Position: OWNER
Credential:
Phone: 419-297-0637