MEDICARE: MED MOTION TRANSPORT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1235903337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED MOTION TRANSPORT LLC

Provider Business Mailing Address
First Line	:	240 IONIA AVE SW APT 511
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-3112
Country	:	US
Telephone Number	:	616-635-5155
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 IONIA AVE SW APT 511
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-3112
Country	:	US
Telephone Number	:	616-635-5155
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABDULKERIM OMAR MUSTAFA
Credential	:
Telephone Number	:	616-635-5155

Provider Enumeration Date	:	11/08/2023
Last Update Date	:	11/16/2023

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Directions to “MED MOTION TRANSPORT LLC ” Practice Location

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