Provider Demographics
NPI:1770253403
Name:ABC EXPRESS MEDICAL TRANS, LLC
Entity Type:Organization
Organization Name:ABC EXPRESS MEDICAL TRANS, LLC
Other - Org Name:ABC EXPRESS MEDICAL TRANS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AHEMED
Authorized Official - Middle Name:MOHAMMEDNUR
Authorized Official - Last Name:RAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-975-8266
Mailing Address - Street 1:804 JAMIE CIR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-5218
Mailing Address - Country:US
Mailing Address - Phone:615-975-8266
Mailing Address - Fax:
Practice Address - Street 1:804 JAMIE CIR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-5218
Practice Address - Country:US
Practice Address - Phone:615-975-8266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)