Provider Demographics
NPI:1316836224
Name:MEDTRUSTWAY LLC
Entity type:Organization
Organization Name:MEDTRUSTWAY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SHIMELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KITANCHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-458-8403
Mailing Address - Street 1:1104 DOWNS DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2030
Mailing Address - Country:US
Mailing Address - Phone:571-458-8403
Mailing Address - Fax:
Practice Address - Street 1:1104 DOWNS DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2030
Practice Address - Country:US
Practice Address - Phone:571-458-8403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)