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General NPI Number Information
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NPI Number | 1922872134
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Entity Type | Organization
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Legal Business Name | MIDWEST MEDICAL TRANSPORT LLC
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Dates
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Enumeration Date | 11/08/2023
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 5792 ARROWHEAD DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3219
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Country | US
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Telephone | 800-562-3396
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3727
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City | OMAHA
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State | NE
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Zip | 68103-0727
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ED K MATTESON
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Credential |
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Telephone | 708-308-4113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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