Organization
BLK NON MEDICAL TRANSPORTATION
Active
Organization
BLK NON MEDICAL TRANSPORTATION
Active
Parent organization
MAVERICK ONE INC
Other names
blk non medical transportation
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAVERICK ONE INC
Authorized official
IVY GREGORY (CO OWNER)
(313) 333-3952
Entity
Organization
Contact information
Practice address
15700 ROSEMONT AVE, DETROIT, MI 48223-1330
(313) 333-3952
Mailing address
15700 ROSEMONT AVE, DETROIT, MI 48223-1330
(313) 333-3952
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
01/07/2019
Last updated
04/16/2020
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