Provider Demographics
NPI:1851585251
Name:HEAL MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:HEAL MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAISAL
Authorized Official - Middle Name:H
Authorized Official - Last Name:ELHASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-315-8884
Mailing Address - Street 1:5220 W. NORTHERN AVE.
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301
Mailing Address - Country:US
Mailing Address - Phone:602-315-8884
Mailing Address - Fax:623-249-5444
Practice Address - Street 1:5220 W NORTHERN AVE APT 209
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-1410
Practice Address - Country:US
Practice Address - Phone:602-315-8884
Practice Address - Fax:623-249-5444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ144894343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ144894OtherPROVIDER NUMBER