Provider Demographics
NPI:1427818020
Name:IMEDIC TRANSPORTATION LLC
Entity type:Organization
Organization Name:IMEDIC TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:469-565-2463
Mailing Address - Street 1:8430 STERLING ST STE B
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-1903
Mailing Address - Country:US
Mailing Address - Phone:469-565-2463
Mailing Address - Fax:
Practice Address - Street 1:8430 STERLING ST STE B
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-1903
Practice Address - Country:US
Practice Address - Phone:469-565-2463
Practice Address - Fax:469-565-2234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20522956Medicaid