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General NPI Number Information
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NPI Number | 1578335287
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Entity Type | Organization
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Legal Business Name | MEDINEEDS MEDTOUR
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Dates
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Enumeration Date | 10/25/2023
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 13105 MOSS RANCH LN
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City | FAIRFAX
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State | VA
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Zip | 22033-3525
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Country | US
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Telephone | 240-755-3272
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Fax |
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Provider Business Mailing Address
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Address Line | 11429 DUNLORING PL
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-5758
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Country | US
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Telephone | 240-755-3272
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Fax |
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Authorized Official
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Title or Position | MD
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Name | OLAMIDOTUN OMOLOSO
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Credential |
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Telephone | 240-755-3272
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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 |
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