Provider Demographics
NPI:1134828767
Name:WESTERN MED TRANS LLC
Entity type:Organization
Organization Name:WESTERN MED TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOMIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDELGADIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-919-9949
Mailing Address - Street 1:1220 E MEDLOCK DR APT 109
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3327
Mailing Address - Country:US
Mailing Address - Phone:602-919-9949
Mailing Address - Fax:
Practice Address - Street 1:1220 E MEDLOCK DR APT 109
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-3327
Practice Address - Country:US
Practice Address - Phone:602-919-9949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)