Provider Demographics
NPI:1518244474
Name:AT MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:AT MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NVER
Authorized Official - Middle Name:
Authorized Official - Last Name:TADEVOSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-451-7600
Mailing Address - Street 1:408 N BLACKSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701-1917
Mailing Address - Country:US
Mailing Address - Phone:559-451-7600
Mailing Address - Fax:559-522-0309
Practice Address - Street 1:408 N BLACKSTONE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-1917
Practice Address - Country:US
Practice Address - Phone:559-451-7600
Practice Address - Fax:559-522-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD2737443343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)