Provider Demographics
NPI:1689941221
Name:SMARTTRANS AMBULANCE SERVICE
Entity Type:Organization
Organization Name:SMARTTRANS AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TARIK
Authorized Official - Middle Name:
Authorized Official - Last Name:FADLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-867-5636
Mailing Address - Street 1:PO BOX 26006
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-0706
Mailing Address - Country:US
Mailing Address - Phone:410-560-5760
Mailing Address - Fax:
Practice Address - Street 1:10866 YORK RD
Practice Address - Street 2:SUITE M
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-2179
Practice Address - Country:US
Practice Address - Phone:410-560-5760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance