Provider Demographics
NPI:1851164339
Name:CRYSTAL CARE TRANSIT, LLC
Entity Type:Organization
Organization Name:CRYSTAL CARE TRANSIT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER, CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAMDI
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-710-7534
Mailing Address - Street 1:2308 HASKELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013
Mailing Address - Country:US
Mailing Address - Phone:615-710-7534
Mailing Address - Fax:
Practice Address - Street 1:2308 HASKELL DRIVE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013
Practice Address - Country:US
Practice Address - Phone:615-710-7534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)