Provider Demographics
NPI:1619648680
Name:MM MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:MM MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-281-2882
Mailing Address - Street 1:3340 BRECKENRIDGE LN APT 5
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-3238
Mailing Address - Country:US
Mailing Address - Phone:502-716-4590
Mailing Address - Fax:
Practice Address - Street 1:3340 BRECKENRIDGE LN APT 5
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-3238
Practice Address - Country:US
Practice Address - Phone:502-716-4590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)