Organization
XTRA MILE TRANSPORT NEMT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET HODGES (OWNER)
(708) 299-7210
Entity
Organization
Contact information
Practice address
16611 ELM ST, SOUTH HOLLAND, IL 60473-2930
(708) 299-7210
Mailing address
16611 ELM ST, SOUTH HOLLAND, IL 60473-2930
(708) 299-7210
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
IL
Other
Enumeration date
12/10/2014
Last updated
02/16/2015
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