Provider Demographics
NPI:1295441871
Name:PRAISE MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:PRAISE MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLALEKAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EGBEYEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-271-5188
Mailing Address - Street 1:616 MANCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-2714
Mailing Address - Country:US
Mailing Address - Phone:708-271-5188
Mailing Address - Fax:
Practice Address - Street 1:616 MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2714
Practice Address - Country:US
Practice Address - Phone:708-271-5188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)