Provider Demographics
NPI:1659849164
Name:NOVA MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:NOVA MEDICAL TRANSPORTATION LLC
Other - Org Name:NOVA MEDICAL TRANSPORTATION LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EYOB
Authorized Official - Middle Name:H
Authorized Official - Last Name:MICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-785-5716
Mailing Address - Street 1:18808 HUNTINGTOWER CASTLE BLVD
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7464
Mailing Address - Country:US
Mailing Address - Phone:512-962-7372
Mailing Address - Fax:
Practice Address - Street 1:18808 HUNTINGTOWER CASTLE BLVD
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7464
Practice Address - Country:US
Practice Address - Phone:512-962-7372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)