Provider Demographics
NPI:1093188195
Name:MD TRANSIT
Entity Type:Organization
Organization Name:MD TRANSIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELKAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMISSIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-744-3391
Mailing Address - Street 1:1833 CHEDDAR LOOP APT 812
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-4010
Mailing Address - Country:US
Mailing Address - Phone:512-744-3391
Mailing Address - Fax:
Practice Address - Street 1:1833 CHEDDAR LOOP APT 812
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-4010
Practice Address - Country:US
Practice Address - Phone:512-744-3391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle