Provider Demographics
NPI:1316393432
Name:UNISON TRANSPORT
Entity Type:Organization
Organization Name:UNISON TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABIY
Authorized Official - Middle Name:
Authorized Official - Last Name:GELETA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-668-5890
Mailing Address - Street 1:362 E PARK CREEKE LN
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-4080
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:362 E PARK CREEKE LN
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-4080
Practice Address - Country:US
Practice Address - Phone:801-668-5890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-07
Last Update Date:2016-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1001957343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)