Provider Demographics
NPI:1609632595
Name:ELSAMAN MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:ELSAMAN MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOSSALEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-515-1214
Mailing Address - Street 1:15310 AMBERLY DR STE 250
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1642
Mailing Address - Country:US
Mailing Address - Phone:813-235-7254
Mailing Address - Fax:
Practice Address - Street 1:1650 FENNSBURY COURT
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544
Practice Address - Country:US
Practice Address - Phone:813-235-7254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELSAMAN TRADING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)