Provider Demographics
NPI:1184342768
Name:SAFE MEDICAL TRANSPORT CORP
Entity type:Organization
Organization Name:SAFE MEDICAL TRANSPORT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANWAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOULEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-679-4111
Mailing Address - Street 1:8439 NOTTINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459-2251
Mailing Address - Country:US
Mailing Address - Phone:708-679-4111
Mailing Address - Fax:
Practice Address - Street 1:8439 NOTTINGHAM AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-2251
Practice Address - Country:US
Practice Address - Phone:708-679-4111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty