Provider Demographics
NPI:1548031099
Name:MERCYME TRANSPORTATION
Entity type:Organization
Organization Name:MERCYME TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MIHRET
Authorized Official - Middle Name:WORKU
Authorized Official - Last Name:KEBEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-789-1284
Mailing Address - Street 1:518 ROCK ROSE LN
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-1966
Mailing Address - Country:US
Mailing Address - Phone:720-789-1284
Mailing Address - Fax:
Practice Address - Street 1:518 ROCK ROSE LN
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-1966
Practice Address - Country:US
Practice Address - Phone:720-789-1284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle