Provider Demographics
NPI:1386228955
Name:SMD MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:SMD MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER- MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADEOLA
Authorized Official - Middle Name:RANDOLPH
Authorized Official - Last Name:ST MATTHEW-DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-282-2010
Mailing Address - Street 1:119 POST CREST DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-3329
Mailing Address - Country:US
Mailing Address - Phone:972-598-4997
Mailing Address - Fax:
Practice Address - Street 1:119 POST CREST DR
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-3329
Practice Address - Country:US
Practice Address - Phone:972-598-4997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)