Provider Demographics
NPI:1396510962
Name:UNITY MED SERVICE
Entity type:Organization
Organization Name:UNITY MED SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OLOUWACHEGOUN
Authorized Official - Middle Name:PHILIPPE
Authorized Official - Last Name:AGBADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-278-8737
Mailing Address - Street 1:900 REBECCA DR
Mailing Address - Street 2:
Mailing Address - City:CARBON CLIFF
Mailing Address - State:IL
Mailing Address - Zip Code:61239-7006
Mailing Address - Country:US
Mailing Address - Phone:309-278-8737
Mailing Address - Fax:
Practice Address - Street 1:900 REBECCA DR
Practice Address - Street 2:
Practice Address - City:CARBON CLIFF
Practice Address - State:IL
Practice Address - Zip Code:61239-7006
Practice Address - Country:US
Practice Address - Phone:309-278-8737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-23
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)