Provider Demographics
NPI:1689387755
Name:MLATX TRANSPORTATION LLC
Entity Type:Organization
Organization Name:MLATX TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELAKU
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-357-9082
Mailing Address - Street 1:1501 S HEATHERWILDE BLVD APT 418
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-4565
Mailing Address - Country:US
Mailing Address - Phone:956-357-9082
Mailing Address - Fax:
Practice Address - Street 1:1501 S HEATHERWILDE BLVD APT 418
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-4565
Practice Address - Country:US
Practice Address - Phone:956-357-9082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)