Healthcare Provider Details

I. General information

NPI: 1962958116
Provider Name (Legal Business Name): UNITED MEDICAL TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4428 SECOR RD
TOLEDO OH
43623-4264
US

IV. Provider business mailing address

4428 SECOR RD
TOLEDO OH
43623
US

V. Phone/Fax

Practice location:
  • Phone: 419-699-9445
  • Fax: 419-214-0180
Mailing address:
  • Phone: 419-699-9445
  • Fax: 419-214-0180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number3929991
License Number StateOH

VIII. Authorized Official

Name: FATUMA I BARQADLE
Title or Position: OWNER
Credential:
Phone: 419-699-9445