Provider Demographics
NPI:1164816823
Name:GOLDA-AMIT INCORPORATED
Entity Type:Organization
Organization Name:GOLDA-AMIT INCORPORATED
Other - Org Name:AMIT HEALTH SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:SAMSON
Authorized Official - Last Name:SHITTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-739-7745
Mailing Address - Street 1:11919 TARRAGON RD APT A
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-3177
Mailing Address - Country:US
Mailing Address - Phone:443-739-7745
Mailing Address - Fax:888-259-1372
Practice Address - Street 1:11919 TARRAGON RD, APT A
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136
Practice Address - Country:US
Practice Address - Phone:443-739-7745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNS1309014251X00000X
MD343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251X00000XAgenciesSupports Brokerage