Provider Demographics
NPI:1851635841
Name:ULTIMATE MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:ULTIMATE MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KHODR
Authorized Official - Middle Name:
Authorized Official - Last Name:HOJAIJE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-399-0753
Mailing Address - Street 1:2012 MONROE ST STE 104
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2938
Mailing Address - Country:US
Mailing Address - Phone:313-399-0753
Mailing Address - Fax:313-274-8201
Practice Address - Street 1:2012 MONROE ST STE 104
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2938
Practice Address - Country:US
Practice Address - Phone:313-399-0753
Practice Address - Fax:313-274-8201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)