Provider Demographics
NPI:1508204611
Name:LIFE CARE MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:LIFE CARE MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YASSIN
Authorized Official - Middle Name:ABDIKHANI
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-316-6649
Mailing Address - Street 1:3353 THORNAPPLE CIR N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6161
Mailing Address - Country:US
Mailing Address - Phone:614-316-6649
Mailing Address - Fax:
Practice Address - Street 1:3353 THORNAPPLE CIR N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6161
Practice Address - Country:US
Practice Address - Phone:614-316-6649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH040YHQ343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)