Provider Demographics
NPI:1376055467
Name:MP MEDICAL TRANSPORT, LLC
Entity type:Organization
Organization Name:MP MEDICAL TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NON-EMERGENCY MEDICAL TRANSP DRIVER
Authorized Official - Prefix:MR
Authorized Official - First Name:SUHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-627-6491
Mailing Address - Street 1:9408 SILVER METEOR CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS PARK
Mailing Address - State:VA
Mailing Address - Zip Code:20111-3000
Mailing Address - Country:US
Mailing Address - Phone:703-627-6491
Mailing Address - Fax:571-379-8587
Practice Address - Street 1:9408 SILVER METEOR CT
Practice Address - Street 2:
Practice Address - City:MANASSAS PARK
Practice Address - State:VA
Practice Address - Zip Code:20111-3000
Practice Address - Country:US
Practice Address - Phone:703-627-6491
Practice Address - Fax:571-379-8587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-29
Last Update Date:2017-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)