Provider Demographics
NPI:1285207001
Name:ARDI 4TRANS
Entity Type:Organization
Organization Name:ARDI 4TRANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IHAB
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:SHAHWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-306-1289
Mailing Address - Street 1:8101 SHIN OAK DR APT 3200
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-2465
Mailing Address - Country:US
Mailing Address - Phone:732-306-1289
Mailing Address - Fax:
Practice Address - Street 1:8101 SHIN OAK DR APT 3200
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-2465
Practice Address - Country:US
Practice Address - Phone:732-306-1289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)