Provider Demographics
NPI:1093957227
Name:ADVANCE MEDICAL TRANSPORTATION COMPANY
Entity Type:Organization
Organization Name:ADVANCE MEDICAL TRANSPORTATION COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:Y
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-382-6837
Mailing Address - Street 1:400 HIALEAH DR.
Mailing Address - Street 2:#42
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996
Mailing Address - Country:US
Mailing Address - Phone:865-382-6837
Mailing Address - Fax:
Practice Address - Street 1:400 HIALEAH DR.
Practice Address - Street 2:#42
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996
Practice Address - Country:US
Practice Address - Phone:865-382-6837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)