Healthcare Provider Details

I. General information

NPI: 1487451282
Provider Name (Legal Business Name): J. MEDI TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2106 PORTSMOUTH DR
RICHARDSON TX
75082-4838
US

IV. Provider business mailing address

2106 PORTSMOUTH DR
RICHARDSON TX
75082-4838
US

V. Phone/Fax

Practice location:
  • Phone: 919-986-2092
  • Fax:
Mailing address:
  • Phone: 919-986-2092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER CHANA HINES
Title or Position: FOUNDER
Credential: MD, MBA
Phone: 919-986-2092