Healthcare Provider Details

I. General information

NPI: 1073447223
Provider Name (Legal Business Name): MERCY TRANSPORTATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 MORNINGSIDE DR
EAU CLAIRE WI
54703-3312
US

IV. Provider business mailing address

813 MORNINGSIDE DR
EAU CLAIRE WI
54703-3312
US

V. Phone/Fax

Practice location:
  • Phone: 615-612-9566
  • Fax:
Mailing address:
  • Phone: 615-612-9566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED SHARIF OMAR
Title or Position: MANAGER
Credential:
Phone: 612-503-6940