Provider Demographics
NPI:1639906696
Name:MEDWAY TRANSIT LLC
Entity type:Organization
Organization Name:MEDWAY TRANSIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIAZIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:HILOWLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-223-5102
Mailing Address - Street 1:2407 COUNTY ROAD 74 APT 204
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-7410
Mailing Address - Country:US
Mailing Address - Phone:320-223-5102
Mailing Address - Fax:
Practice Address - Street 1:22 WILSON AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56304-0406
Practice Address - Country:US
Practice Address - Phone:320-223-5102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)