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General NPI Number Information
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NPI Number | 1639531585
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Entity Type | Organization
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Legal Business Name | MEDICAL TRANSPORT INC.
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Dates
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Enumeration Date | 03/21/2016
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Last Update Date | 03/21/2016
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Provider Practice Location Address
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Address Line | 118 E STEVENSON DR
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City | GLENDALE HEIGHTS
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State | IL
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Zip | 60139-2055
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Country | US
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Telephone | 630-247-8151
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Fax | 630-855-6012
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Provider Business Mailing Address
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Address Line | 118 E STEVENSON DR
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City | GLENDALE HEIGHTS
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State | IL
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Zip | 60139-2055
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Country | US
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Telephone | 630-247-8151
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Fax | 630-855-6012
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MAQBOOL AHMED
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Credential |
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Telephone | 630-247-8151
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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 | 17496 PT
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License Number State | IL
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