Provider Demographics
NPI:1114890100
Name:MEDTRANSPO LLC
Entity type:Organization
Organization Name:MEDTRANSPO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CRANIAL PROSTHESES SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:AKILAH
Authorized Official - Middle Name:H
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-803-8111
Mailing Address - Street 1:3509 DULUTH HIGHWAY 120
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-6703
Mailing Address - Country:US
Mailing Address - Phone:678-803-8111
Mailing Address - Fax:
Practice Address - Street 1:3509 DULUTH HIGHWAY 120
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-6703
Practice Address - Country:US
Practice Address - Phone:678-803-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies