Provider Demographics
NPI:1225523723
Name:OPTIMA TRANSPORTATION
Entity Type:Organization
Organization Name:OPTIMA TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ZELALEM
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-505-1055
Mailing Address - Street 1:4705 EISENHOWER AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-4805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4705 EISENHOWER AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-4805
Practice Address - Country:US
Practice Address - Phone:202-505-1055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)