Provider Demographics
NPI:1932426673
Name:NORTHWEST MED. TRANS., INC
Entity type:Organization
Organization Name:NORTHWEST MED. TRANS., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OGANES
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-241-3737
Mailing Address - Street 1:417 ARDEN AVE
Mailing Address - Street 2:211
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-4045
Mailing Address - Country:US
Mailing Address - Phone:818-241-3737
Mailing Address - Fax:818-548-2474
Practice Address - Street 1:417 ARDEN AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-4045
Practice Address - Country:US
Practice Address - Phone:818-241-3737
Practice Address - Fax:818-548-2474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========Medicaid