Provider Demographics
NPI:1427587633
Name:SUNSHINE MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:SUNSHINE MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AWADALLA
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-528-6000
Mailing Address - Street 1:1142 MEADOW SAGE LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4928
Mailing Address - Country:US
Mailing Address - Phone:804-528-6000
Mailing Address - Fax:757-233-9248
Practice Address - Street 1:1142 MEADOW SAGE LN
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4928
Practice Address - Country:US
Practice Address - Phone:804-528-6000
Practice Address - Fax:757-233-9248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAA64286293Medicaid