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Organization

QUICK TRIP MEDICAL TRANSPORTATION, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WALI KARRIEM JACKSON (OWNER)
(219) 955-2825
Entity
Organization

Contact information

Practice address
3032 RANDOLPH ST, PORTAGE, IN 46368-4242
(219) 955-2825
Mailing address
3032 RANDOLPH ST, PORTAGE, IN 46368-4242
(219) 955-2825

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
10/24/2024
Last updated
10/24/2024
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