Provider Demographics
NPI:1265801690
Name:ON TIME NON-EMERGENCY MEDICAL TRANSPORTATION, LLC
Entity type:Organization
Organization Name:ON TIME NON-EMERGENCY MEDICAL TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANDRE
Authorized Official - Last Name:WYATT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:810-874-8536
Mailing Address - Street 1:1819 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-4051
Mailing Address - Country:US
Mailing Address - Phone:810-874-8536
Mailing Address - Fax:
Practice Address - Street 1:1819 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-4051
Practice Address - Country:US
Practice Address - Phone:810-874-8536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)