Provider Demographics
NPI:1235903337
Name:MED MOTION TRANSPORT LLC
Entity Type:Organization
Organization Name:MED MOTION TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDULKERIM
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:MUSTAFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-635-5155
Mailing Address - Street 1:240 IONIA AVE SW APT 511
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-3112
Mailing Address - Country:US
Mailing Address - Phone:616-635-5155
Mailing Address - Fax:
Practice Address - Street 1:240 IONIA AVE SW APT 511
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-3112
Practice Address - Country:US
Practice Address - Phone:616-635-5155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-08
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)