Provider Demographics
NPI:1508634940
Name:SAFE DRIVE 1 LLC
Entity Type:Organization
Organization Name:SAFE DRIVE 1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAITH
Authorized Official - Middle Name:ABDALFATTAH
Authorized Official - Last Name:ABUOMRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-656-1393
Mailing Address - Street 1:631 FARRELL ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:TN
Mailing Address - Zip Code:38581-3642
Mailing Address - Country:US
Mailing Address - Phone:540-656-1393
Mailing Address - Fax:
Practice Address - Street 1:631 FARRELL ROGERS RD
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:TN
Practice Address - Zip Code:38581-3642
Practice Address - Country:US
Practice Address - Phone:540-656-1393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)