Provider Demographics
NPI:1437251543
Name:LIFE TRANSMED INC.
Entity Type:Organization
Organization Name:LIFE TRANSMED INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ODER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-934-6111
Mailing Address - Street 1:2667 CONEY ISLAND AVE # 2-FLOOR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5520
Mailing Address - Country:US
Mailing Address - Phone:718-934-6111
Mailing Address - Fax:718-934-2378
Practice Address - Street 1:2667 CONEY ISLAND AVE # 2-FLOOR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5520
Practice Address - Country:US
Practice Address - Phone:718-934-6111
Practice Address - Fax:718-934-2378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)