Provider Demographics
NPI:1275681694
Name:AJ'S MEDICAL TRANSPORT INC.
Entity Type:Organization
Organization Name:AJ'S MEDICAL TRANSPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-781-5455
Mailing Address - Street 1:13310 REEDLEY ST
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4022
Mailing Address - Country:US
Mailing Address - Phone:818-781-5455
Mailing Address - Fax:818-787-6768
Practice Address - Street 1:13310 REEDLEY ST
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4022
Practice Address - Country:US
Practice Address - Phone:818-781-5455
Practice Address - Fax:818-787-6768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN00977FMedicaid