Provider Demographics
NPI:1326740218
Name:AZIZKO MEDICAL TRANS LLC
Entity Type:Organization
Organization Name:AZIZKO MEDICAL TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESAMEDLIN
Authorized Official - Middle Name:NOURELDIN
Authorized Official - Last Name:ABDELAZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-313-9425
Mailing Address - Street 1:6615 N 17TH AVE APT 26
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1333
Mailing Address - Country:US
Mailing Address - Phone:619-313-9425
Mailing Address - Fax:
Practice Address - Street 1:6615 N 17TH AVE APT 26
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1333
Practice Address - Country:US
Practice Address - Phone:619-313-9425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)