Provider Demographics
NPI:1730468802
Name:LIFE CARE MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:LIFE CARE MEDICAL TRANSPORTATION
Other - Org Name:LIFE CARE MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:ABDI
Authorized Official - Last Name:ARAB
Authorized Official - Suffix:SR
Authorized Official - Credentials:MA
Authorized Official - Phone:614-592-8034
Mailing Address - Street 1:2700 CROSSROADS PLAZA DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3442
Mailing Address - Country:US
Mailing Address - Phone:614-414-0311
Mailing Address - Fax:614-475-9220
Practice Address - Street 1:2700 CROSSROADS PLAZA DR
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3442
Practice Address - Country:US
Practice Address - Phone:614-414-0311
Practice Address - Fax:614-475-9220
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFE CARE MEDICAL TRANSPORTATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSJ178975343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)