Healthcare Provider Details

I. General information

NPI: 1659294833
Provider Name (Legal Business Name): PRIMEMED TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 WOODMERE CT APT 4
APPLETON WI
54911-4043
US

IV. Provider business mailing address

21 WOODMERE CT APT 4
APPLETON WI
54911-4043
US

V. Phone/Fax

Practice location:
  • Phone: 614-312-4794
  • Fax:
Mailing address:
  • Phone: 614-312-4794
  • 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: BASHIR WARSAME
Title or Position: OWNER
Credential:
Phone: 614-312-4794