Provider Demographics
NPI:1235762766
Name:ANAN MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:ANAN MEDICAL TRANSPORTATION
Other - Org Name:ANAN MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HISHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-625-6855
Mailing Address - Street 1:350 CYPRESS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4445
Mailing Address - Country:US
Mailing Address - Phone:804-625-6855
Mailing Address - Fax:
Practice Address - Street 1:350 CYPRESS CREEK RD
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4445
Practice Address - Country:US
Practice Address - Phone:804-625-6855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA843162962Medicaid