Provider Demographics
NPI:1639889546
Name:MRM FAST TRANSPORT LLC
Entity Type:Organization
Organization Name:MRM FAST TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:AMMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDUJAILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-229-2305
Mailing Address - Street 1:6020 RUTLAND DR STE 20
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-0515
Mailing Address - Country:US
Mailing Address - Phone:916-229-2305
Mailing Address - Fax:
Practice Address - Street 1:6020 RUTLAND DR STE 20
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0515
Practice Address - Country:US
Practice Address - Phone:916-229-2305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)