Healthcare Provider Details

I. General information

NPI: 1205305737
Provider Name (Legal Business Name): TRANSIT MEDICAL TEAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 11/22/2022
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 S I-240 SERVICE RD STE F
OKLAHOMA CITY OK
73139
US

IV. Provider business mailing address

1145 W I 240 SERVICE RD STE F100
OKLAHOMA CITY OK
73139-2134
US

V. Phone/Fax

Practice location:
  • Phone: 405-898-9048
  • Fax: 405-400-8798
Mailing address:
  • Phone: 405-898-9048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KIM LELAND
Title or Position: CEO
Credential:
Phone: 405-898-9048