Provider Demographics
NPI:1073004537
Name:MEDITRIP TRANSPORTATION SERVICES,INC.
Entity Type:Organization
Organization Name:MEDITRIP TRANSPORTATION SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:NYAMBIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-809-9791
Mailing Address - Street 1:17356 W 12 MILE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076
Mailing Address - Country:US
Mailing Address - Phone:248-809-9791
Mailing Address - Fax:313-270-7291
Practice Address - Street 1:17356 W 12 MILE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48085
Practice Address - Country:US
Practice Address - Phone:248-809-9791
Practice Address - Fax:313-270-7291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)