Individual
MR. MOHAMED KEITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5030 WARRINGTON AVENUE, PHILADELPHIA, PA 19143
(215) 939-1448
(215) 921-8530
Mailing address
5030 WARRINGTON AVENUE, PHILADELPHIA, PA 19143
(215) 939-1448
(215) 921-8530
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
PA-PUC-A6414780
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102800991
—
PA
Enumeration date
02/06/2019
Last updated
02/06/2019
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