Provider Demographics
NPI:1710601208
Name:TRANQUILITY MEDICAL TRANSPORT LLC
Entity Type:Organization
Organization Name:TRANQUILITY MEDICAL TRANSPORT LLC
Other - Org Name:TRANQUILITY MEDICAL TRANSPORT LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVTYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-385-5659
Mailing Address - Street 1:11490 BURBANK BLVD STE 6H
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-2353
Mailing Address - Country:US
Mailing Address - Phone:818-867-9868
Mailing Address - Fax:
Practice Address - Street 1:11490 BURBANK BLVD STE 6H
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2353
Practice Address - Country:US
Practice Address - Phone:818-867-9868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)