Provider Demographics
NPI:1477216554
Name:MADISON AREA TRANSPORT
Entity Type:Organization
Organization Name:MADISON AREA TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHIYADIN
Authorized Official - Middle Name:O
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-630-6736
Mailing Address - Street 1:2421 CHALET GARDENS CT APT 1
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-4491
Mailing Address - Country:US
Mailing Address - Phone:608-630-6736
Mailing Address - Fax:
Practice Address - Street 1:2421 CHALET GARDENS CT APT 1
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-4491
Practice Address - Country:US
Practice Address - Phone:608-630-6736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)