Provider Demographics
NPI:1518104827
Name:METRO TRANSPORT, LLC
Entity Type:Organization
Organization Name:METRO TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:ELMUSHARAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-373-3056
Mailing Address - Street 1:1741 E THOMAS RD APT 25
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7643
Mailing Address - Country:US
Mailing Address - Phone:602-373-3056
Mailing Address - Fax:
Practice Address - Street 1:1741 E THOMAS RD APT 25
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7643
Practice Address - Country:US
Practice Address - Phone:602-373-3056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD06567622343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)