Provider Demographics
NPI:1093017618
Name:ABBA MEDICAL TRANSPORTATION,LLC
Entity Type:Organization
Organization Name:ABBA MEDICAL TRANSPORTATION,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-721-0911
Mailing Address - Street 1:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:KEASBEY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-1642
Mailing Address - Country:US
Mailing Address - Phone:732-721-0911
Mailing Address - Fax:732-721-0919
Practice Address - Street 1:110 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879
Practice Address - Country:US
Practice Address - Phone:732-721-0911
Practice Address - Fax:732-721-0919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)