Provider Demographics
NPI:1457086852
Name:AJ MEDTRANS
Entity Type:Organization
Organization Name:AJ MEDTRANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAHIMAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-525-3806
Mailing Address - Street 1:5151 N 95TH AVE APT 3013
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-3067
Mailing Address - Country:US
Mailing Address - Phone:347-525-3806
Mailing Address - Fax:
Practice Address - Street 1:5151 N 95TH AVE APT 3013
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-3067
Practice Address - Country:US
Practice Address - Phone:347-525-3806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)