=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669398392
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | URGENT MEDICAL TRANSPORT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2026
-----------------------------------------------------
Last Update Date | 06/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5622 PACIFIC AVE SE STE 5
-----------------------------------------------------
City | LACEY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98503-1271
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-515-0699
-----------------------------------------------------
Fax | 360-878-9046
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5622 PACIFIC AVE SE STE 5
-----------------------------------------------------
City | LACEY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98503-1271
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-515-0699
-----------------------------------------------------
Fax | 360-878-9046
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ABOBAKKR DIRAR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 360-515-0699
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 342000000X
-----------------------------------------------------
Taxonomy Name | Transportation Network Company
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------