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General NPI Number Information
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NPI Number | 1194594671
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Entity Type | Organization
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Legal Business Name | DELTA MEDICAL TRANSPORTATION
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Dates
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Enumeration Date | 12/26/2023
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Last Update Date | 12/26/2023
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Provider Practice Location Address
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Address Line | 8220 25TH CT
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City | KENOSHA
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State | WI
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Zip | 53143-6277
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Country | US
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Telephone | 703-953-7445
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Fax |
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Provider Business Mailing Address
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Address Line | 8220 25TH CT
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City | KENOSHA
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State | WI
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Zip | 53143-6277
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Country | US
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Telephone | 703-953-7445
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ISMAIL AHMED ISMAIL
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Credential |
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Telephone | 703-953-7445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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