Provider Demographics
NPI:1821658550
Name:IMPERIAL MEDICAL TRANSPORT INC
Entity Type:Organization
Organization Name:IMPERIAL MEDICAL TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:MUMIN
Authorized Official - Last Name:ADDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-729-5213
Mailing Address - Street 1:2667 CAMINO DEL RIO S STE 100C
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3771
Mailing Address - Country:US
Mailing Address - Phone:619-729-5213
Mailing Address - Fax:
Practice Address - Street 1:2667 CAMINO DEL RIO S STE 100C
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3771
Practice Address - Country:US
Practice Address - Phone:619-729-5213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-14
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)