Provider Demographics
NPI:1225652621
Name:UNITED MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:UNITED MEDICAL TRANSPORT LLC
Other - Org Name:UNITED MEDICAL TRANSPORT LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DHERGANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-699-9445
Mailing Address - Street 1:5150 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-3151
Mailing Address - Country:US
Mailing Address - Phone:419-514-3975
Mailing Address - Fax:419-214-0180
Practice Address - Street 1:5150 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-3151
Practice Address - Country:US
Practice Address - Phone:419-514-3975
Practice Address - Fax:419-214-0180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1225652621OtherNPI