Provider Demographics
NPI:1235683327
Name:AHA LLC
Entity Type:Organization
Organization Name:AHA LLC
Other - Org Name:AHA FAMILY LOGISTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:IVETTE
Authorized Official - Last Name:MERENDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-803-0019
Mailing Address - Street 1:3317 PECAN SHADOW WAY
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-2941
Mailing Address - Country:US
Mailing Address - Phone:469-803-0019
Mailing Address - Fax:469-327-3007
Practice Address - Street 1:3317 PECAN SHADOW WAY
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-2941
Practice Address - Country:US
Practice Address - Phone:469-803-0019
Practice Address - Fax:469-327-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-07
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBGP9759343900000X
TXJHF4367343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)