Provider Demographics
NPI:1114695939
Name:CROSSTOWN MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:CROSSTOWN MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:FAQI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-279-1801
Mailing Address - Street 1:5810 SOUTHWYCK BLVD STE 200F
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1514
Mailing Address - Country:US
Mailing Address - Phone:419-279-1801
Mailing Address - Fax:419-718-0083
Practice Address - Street 1:5810 SOUTHWYCK BLVD STE 200F
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1514
Practice Address - Country:US
Practice Address - Phone:419-279-1801
Practice Address - Fax:419-718-0083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-06
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)