Provider Demographics
NPI:1245011485
Name:PROGRESS NON-MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:PROGRESS NON-MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ELIJAH
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:HESHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-721-2381
Mailing Address - Street 1:5517 34TH AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-5658
Mailing Address - Country:US
Mailing Address - Phone:309-721-2381
Mailing Address - Fax:
Practice Address - Street 1:5517 34TH AVE APT 4
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-5658
Practice Address - Country:US
Practice Address - Phone:309-721-2381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)