Provider Demographics
NPI:1306651070
Name:MOBAH TRANSPORT LLC
Entity type:Organization
Organization Name:MOBAH TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:BAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-669-2181
Mailing Address - Street 1:1734 FAIR PHEASANT WAY
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-9419
Mailing Address - Country:US
Mailing Address - Phone:608-669-2181
Mailing Address - Fax:
Practice Address - Street 1:1023 BETHANY CT
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-3716
Practice Address - Country:US
Practice Address - Phone:608-669-2181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)