Healthcare Provider Details

I. General information

NPI: 1629990809
Provider Name (Legal Business Name): JAYJAY TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 MOORLAND RD APT 103
MADISON WI
53713-3919
US

IV. Provider business mailing address

675 MOORLAND RD APT 103
MADISON WI
53713-3919
US

V. Phone/Fax

Practice location:
  • Phone: 614-772-1032
  • Fax:
Mailing address:
  • Phone: 614-772-1032
  • 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: MAHAD GALLAD LIPAN
Title or Position: OWNER
Credential:
Phone: 614-772-1032