Provider Demographics
NPI:1407969769
Name:MIDWAY MEDICAL TRANSPORT, INC.
Entity Type:Organization
Organization Name:MIDWAY MEDICAL TRANSPORT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/REGISTERED
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-B
Authorized Official - Phone:252-661-2090
Mailing Address - Street 1:PO BOX 57
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NC
Mailing Address - Zip Code:27840-0057
Mailing Address - Country:US
Mailing Address - Phone:252-661-2090
Mailing Address - Fax:252-825-1818
Practice Address - Street 1:107 W. LIBERTY STREET
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NC
Practice Address - Zip Code:27840
Practice Address - Country:US
Practice Address - Phone:252-661-2090
Practice Address - Fax:252-825-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1609341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406820Medicaid
NC2783143Medicare ID - Type UnspecifiedPROVIDER NUMBER
NC3406820Medicaid