Provider Demographics
NPI:1568043586
Name:AMEN NON-EMERGENCY TRANSPORTATION SERVICE LLC
Entity Type:Organization
Organization Name:AMEN NON-EMERGENCY TRANSPORTATION SERVICE LLC
Other - Org Name:AMEN NON-EMERGENCY TRANSPORTATION SERVICE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ESAYAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MELAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-215-8609
Mailing Address - Street 1:6236 HORTON CIR APT 36A
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-3765
Mailing Address - Country:US
Mailing Address - Phone:972-215-8609
Mailing Address - Fax:
Practice Address - Street 1:6236 HORTON CIR APT 36A
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-3765
Practice Address - Country:US
Practice Address - Phone:972-215-8609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)