Organization
GREAT LAKES PORTER SVC
Active
Organization
GREAT LAKES PORTER SVC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AHMED AHMED (PRESIDENT)
(313) 478-6699
Entity
Organization
Contact information
Practice address
5296 HARTWELL ST, DEARBORN, MI 48126-3310
(313) 478-6699
Mailing address
25411 W WARREN ST, DEARBORN HEIGHTS, MI 48127-3830
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
A530035029696
MI
Other
Enumeration date
06/04/2010
Last updated
06/04/2010
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