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NPI Code Detail

MEDICARE: IMANI MEDICAL TRANSPORTATION LLC

MEDICARE: IMANI MEDICAL TRANSPORTATION 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
1343800000XSecured Medical Transport (VAN)

General Provider Information

NPI Number : 1396295176
Entity Type Code : Organization
Provider Name (Legal Business Name) : IMANI MEDICAL TRANSPORTATION LLC
Provider Business Mailing Address
First Line : 14427 BENNINGCREST LN
Second Line :
City : HOUSTON
State : TX
Zip : 77047-7527
Country : US
Telephone Number : 346-248-8348
Fax Number : 832-553-7811
Provider Business Practice Location Address
First Line : 5718 WESTHEIMER RD STE 1000
Second Line :
City : HOUSTON
State : TX
Zip : 77057-9903
Country : US
Telephone Number : 346-248-8348
Fax Number : 832-553-7811
Authorized Official
Title or Position : OWNER
Name : MS. KRYSTAL HUMPHREY
Credential :
Telephone Number : 346-248-8348
Provider Enumeration Date : 10/05/2016
Last Update Date : 02/07/2022

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Directions to “IMANI MEDICAL TRANSPORTATION LLC ” Practice Location

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