Provider Demographics
NPI:1255179172
Name:M&M COURTESY TRANSPORTATION LLC
Entity type:Organization
Organization Name:M&M COURTESY TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MUSTAPHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-343-8538
Mailing Address - Street 1:213 W COTTAGE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53527-9327
Mailing Address - Country:US
Mailing Address - Phone:231-343-8538
Mailing Address - Fax:608-839-0842
Practice Address - Street 1:213 W COTTAGE GROVE RD
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:WI
Practice Address - Zip Code:53527-9327
Practice Address - Country:US
Practice Address - Phone:231-343-8538
Practice Address - Fax:608-839-0842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)