Provider Demographics
NPI:1194594671
Name:DELTA MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:DELTA MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISMAIL
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:ISMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-953-7445
Mailing Address - Street 1:8220 25TH CT
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53143-6277
Mailing Address - Country:US
Mailing Address - Phone:703-953-7445
Mailing Address - Fax:
Practice Address - Street 1:8220 25TH CT
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53143-6277
Practice Address - Country:US
Practice Address - Phone:703-953-7445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company