Provider Demographics
NPI:1093289605
Name:MERGE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:MERGE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:H
Authorized Official - Last Name:IMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-618-9141
Mailing Address - Street 1:7130 WESTVIEW PL APT C
Mailing Address - Street 2:
Mailing Address - City:LEMON GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:91945-1424
Mailing Address - Country:US
Mailing Address - Phone:619-618-9141
Mailing Address - Fax:
Practice Address - Street 1:7130 WESTVIEW PL APT C
Practice Address - Street 2:
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945-1424
Practice Address - Country:US
Practice Address - Phone:619-618-9141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)