Provider Demographics
NPI:1790206928
Name:CARMEL MEDICAL TRANSPORT, LLC
Entity Type:Organization
Organization Name:CARMEL MEDICAL TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NAFTALI
Authorized Official - Middle Name:NMN
Authorized Official - Last Name:LEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-639-0775
Mailing Address - Street 1:6609 AZALEA GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-5313
Mailing Address - Country:US
Mailing Address - Phone:757-853-0369
Mailing Address - Fax:757-853-0369
Practice Address - Street 1:3300 N MILITARY HWY
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-5609
Practice Address - Country:US
Practice Address - Phone:757-853-0369
Practice Address - Fax:757-853-0369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA463343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)