Provider Demographics
NPI:1609529932
Name:SMOOTH SAIL MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:SMOOTH SAIL MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIVER
Authorized Official - Prefix:
Authorized Official - First Name:KHALEEL
Authorized Official - Middle Name:MOHAMMAD
Authorized Official - Last Name:MOUSSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-521-3962
Mailing Address - Street 1:412 AMBERTON CT
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-5631
Mailing Address - Country:US
Mailing Address - Phone:615-521-3962
Mailing Address - Fax:
Practice Address - Street 1:412 AMBERTON CT
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-5631
Practice Address - Country:US
Practice Address - Phone:615-521-3962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)