Provider Demographics
NPI:1326486689
Name:MIDWEST MEDICAL TRANSPORTATION SERVICES, INC
Entity Type:Organization
Organization Name:MIDWEST MEDICAL TRANSPORTATION SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-560-5175
Mailing Address - Street 1:944 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-5663
Mailing Address - Country:US
Mailing Address - Phone:708-560-5175
Mailing Address - Fax:
Practice Address - Street 1:944 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-5663
Practice Address - Country:US
Practice Address - Phone:708-560-5175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL343800000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)