Provider Demographics
NPI:1215668140
Name:MIRE TRANSPORTATION LLC
Entity type:Organization
Organization Name:MIRE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAJMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAALIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:652-271-0582
Mailing Address - Street 1:3141 MAPLE VALLEY DR APT 102
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-3161
Mailing Address - Country:US
Mailing Address - Phone:651-271-0582
Mailing Address - Fax:
Practice Address - Street 1:3141 MAPLE VALLEY DR APT 102
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-3161
Practice Address - Country:US
Practice Address - Phone:651-271-0582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)