Provider Demographics
NPI:1184316036
Name:ABU TRANSPORTATION LLC
Entity type:Organization
Organization Name:ABU TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YESHI
Authorized Official - Middle Name:
Authorized Official - Last Name:MEKONNEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-506-0450
Mailing Address - Street 1:3417 W ALTA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-5467
Mailing Address - Country:US
Mailing Address - Phone:480-915-5781
Mailing Address - Fax:
Practice Address - Street 1:3417 W ALTA VISTA RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-5467
Practice Address - Country:US
Practice Address - Phone:630-517-8859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)