Provider Demographics
NPI:1275235871
Name:SSA
Entity Type:Organization
Organization Name:SSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDELAZIZ
Authorized Official - Middle Name:YOUSIF
Authorized Official - Last Name:MOSTAFA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:602-919-9959
Mailing Address - Street 1:2431 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288-3102
Mailing Address - Country:US
Mailing Address - Phone:602-919-9959
Mailing Address - Fax:
Practice Address - Street 1:2431 E 7TH ST
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85288-3102
Practice Address - Country:US
Practice Address - Phone:602-919-9959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)