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General NPI Number Information
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NPI Number | 1144506452
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Entity Type | Organization
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Legal Business Name | URBAN MEDICAL TRANSPORT INC
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Dates
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Enumeration Date | 11/01/2011
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Last Update Date | 11/01/2011
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Provider Practice Location Address
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Address Line | 800 S WELLS ST #1236
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City | CHICAGO
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State | IL
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Zip | 60607-4529
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Country | US
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Telephone | 312-404-9528
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Fax | 312-922-1183
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Provider Business Mailing Address
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Address Line | 800 S WELLS ST APT 1236
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City | CHICAGO
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State | IL
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Zip | 60607-4540
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Country | US
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Telephone | 312-404-9528
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Fax | 312-922-1183
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANESHA FULTZ
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Credential |
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Telephone | 312-404-9528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | IN
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