Provider Demographics
NPI:1144040973
Name:M1 TRANSPORT LLC
Entity type:Organization
Organization Name:M1 TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-821-1389
Mailing Address - Street 1:2795 E COTTONWOOD PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-6928
Mailing Address - Country:US
Mailing Address - Phone:720-967-6222
Mailing Address - Fax:
Practice Address - Street 1:2795 E COTTONWOOD PKWY STE 300
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-6928
Practice Address - Country:US
Practice Address - Phone:720-967-6222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)