Provider Demographics
NPI:1871043091
Name:GRAND MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GRAND MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SAYNAB
Authorized Official - Middle Name:MAHMED
Authorized Official - Last Name:MAGAN
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:614-843-8422
Mailing Address - Street 1:2709 CASSADY CT W
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3439
Mailing Address - Country:US
Mailing Address - Phone:614-843-8422
Mailing Address - Fax:614-418-1788
Practice Address - Street 1:2709 CASSADY CT W
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3439
Practice Address - Country:US
Practice Address - Phone:614-843-8422
Practice Address - Fax:614-418-1788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)