Provider Demographics
NPI:1952017238
Name:MEDSTAR TRANSPORTATION LLC
Entity Type:Organization
Organization Name:MEDSTAR TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABDULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-466-7099
Mailing Address - Street 1:N112W12850 MEQUON RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-3624
Mailing Address - Country:US
Mailing Address - Phone:206-466-7099
Mailing Address - Fax:414-763-3492
Practice Address - Street 1:N112W12850 MEQUON RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022-3624
Practice Address - Country:US
Practice Address - Phone:206-466-7099
Practice Address - Fax:414-763-3492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)