Provider Demographics
NPI:1245574581
Name:MEDEX MID-MICHIGAN LLC
Entity Type:Organization
Organization Name:MEDEX MID-MICHIGAN LLC
Other - Org Name:MEDEX PATIENT TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:BURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-625-8896
Mailing Address - Street 1:5401 N BELSAY RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48506-1251
Mailing Address - Country:US
Mailing Address - Phone:810-625-8896
Mailing Address - Fax:
Practice Address - Street 1:5401 N BELSAY RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48506-1251
Practice Address - Country:US
Practice Address - Phone:810-625-8896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)