Provider Demographics
NPI:1124881792
Name:MEDIGO TRANSPORT
Entity type:Organization
Organization Name:MEDIGO TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHUKRULLOHKHON
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHAMMADALIZODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-353-7515
Mailing Address - Street 1:1140 N FRONT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-3160
Mailing Address - Country:US
Mailing Address - Phone:209-202-3220
Mailing Address - Fax:
Practice Address - Street 1:1140 N FRONT ST STE 2
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-3160
Practice Address - Country:US
Practice Address - Phone:209-202-3220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343800000XTransportation ServicesSecured Medical Transport (VAN)