Provider Demographics
NPI:1235824947
Name:DAWN MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:DAWN MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ELSADIG
Authorized Official - Middle Name:
Authorized Official - Last Name:OMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-358-6858
Mailing Address - Street 1:6416 W TOWNLEY AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-4428
Mailing Address - Country:US
Mailing Address - Phone:602-358-6858
Mailing Address - Fax:
Practice Address - Street 1:6416 W TOWNLEY AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4428
Practice Address - Country:US
Practice Address - Phone:602-358-6858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)