Provider Demographics
NPI:1710215058
Name:MEDINN CORP
Entity Type:Organization
Organization Name:MEDINN CORP
Other - Org Name:DALIA AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BASEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MUJARKESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-249-2687
Mailing Address - Street 1:7623 BARBERTON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-5711
Mailing Address - Country:US
Mailing Address - Phone:713-249-2687
Mailing Address - Fax:713-271-8533
Practice Address - Street 1:5800 RANCHESTER DR # 155
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2464
Practice Address - Country:US
Practice Address - Phone:713-249-2687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10003643416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport