# MIDWEST MEDICAL TRANSPORTATION, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013799782
- **Authorized official:** MISS JEANINE RASHONDA JACKSON (OWNER/OPERATOR)
- **Authorized official phone:** (248) 278-2477

## Contact information

- **Practice address:** 995 N. PONTIAC TRAIL, WALLED LAKE, MI 48390-3323
- **Practice address phone:** (248) 278-2477
- **Mailing address:** 995 N. PONTIAC TRAIL, P.O. BOX \# 57, WALLED LAKE, MI 48390-3323
- **Mailing address phone:** (248) 278-2477

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 347C00000X | Private Vehicle | — | NULL | Yes |

## Other

- **Enumeration date:** 10/18/2023
- **Last updated:** 10/19/2023