=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053004952
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | 4M'S MEDICAL TRANSPORTATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/29/2023
-----------------------------------------------------
Last Update Date | 05/29/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2310 SANDRA SUE DR APT I
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63114-1752
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-685-6840
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2310 SANDRA SUE DR APT I
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63114-1752
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-685-6840
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. ELID KARIUKI NDIRANGU
-----------------------------------------------------
Credential | DRIVER
-----------------------------------------------------
Telephone | 314-685-6840
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------