Provider Demographics
NPI:1205603602
Name:MO RELIABLE TRANSPORTATION LLC
Entity type:Organization
Organization Name:MO RELIABLE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:HAMID ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-927-7170
Mailing Address - Street 1:13210 AURORA DR
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4029
Mailing Address - Country:US
Mailing Address - Phone:510-927-7170
Mailing Address - Fax:
Practice Address - Street 1:13210 AURORA DR
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4029
Practice Address - Country:US
Practice Address - Phone:510-927-7170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2024-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)