Provider Demographics
NPI:1518651686
Name:MNM MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:MNM MEDICAL TRANSPORT LLC
Other - Org Name:MNM MEDICAL TRANSPORT LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCKINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-588-6993
Mailing Address - Street 1:2100 N HWY 360 SUITE 2007B PMB 1012
Mailing Address - Street 2:2007B PMB1012
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050
Mailing Address - Country:US
Mailing Address - Phone:469-588-6993
Mailing Address - Fax:
Practice Address - Street 1:2100 N HWY 360 SUITE 2007B PMB 1012
Practice Address - Street 2:2007B PMB1012
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050
Practice Address - Country:US
Practice Address - Phone:469-588-6993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)