Provider Demographics
NPI:1205399276
Name:SOLO 1 TRANSPORTATION LLC
Entity Type:Organization
Organization Name:SOLO 1 TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KHALAF
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:EGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-589-8890
Mailing Address - Street 1:6161 BUSCH BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2556
Mailing Address - Country:US
Mailing Address - Phone:703-589-8958
Mailing Address - Fax:
Practice Address - Street 1:6161 BUSCH BLVD STE 310
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2556
Practice Address - Country:US
Practice Address - Phone:703-589-8958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH253075Medicaid