Provider Demographics
NPI:1942082797
Name:FAST LINE TRUCKING INC
Entity Type:Organization
Organization Name:FAST LINE TRUCKING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELDESSOUKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-268-8708
Mailing Address - Street 1:13562 IRONSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-8823
Mailing Address - Country:US
Mailing Address - Phone:909-268-8708
Mailing Address - Fax:
Practice Address - Street 1:13562 IRONSTONE AVE
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-8823
Practice Address - Country:US
Practice Address - Phone:909-268-8708
Practice Address - Fax:760-241-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)