Organization
123 TRANSPORTATION, LLC
Active
Other names
123 MEDICAL TRANSPORTATION
Organization subpart
No
Provider details
NPI number
Authorized official
MOUNA BAZZY (PRESIDENT)
(313) 799-1340
Entity
Organization
Contact information
Practice address
25134 RIVERDALE ST, DEARBORN, MI 48124-1722
(313) 799-1340
(313) 436-4399
Mailing address
PO BOX 1941, DEARBORN, MI 48121-1941
(313) 799-1340
(313) 436-4399
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
L-2717
MI
Other
Enumeration date
01/10/2012
Last updated
11/06/2012
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