Provider Demographics
NPI:1205322914
Name:LIFESAVERS TRANSPORTATION LLC
Entity type:Organization
Organization Name:LIFESAVERS TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HANI
Authorized Official - Middle Name:
Authorized Official - Last Name:TOTAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-361-6416
Mailing Address - Street 1:1515 AURORA DR STE 101B
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3105
Mailing Address - Country:US
Mailing Address - Phone:510-878-9000
Mailing Address - Fax:510-564-4065
Practice Address - Street 1:1515 AURORA DR STE 101B
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-3105
Practice Address - Country:US
Practice Address - Phone:510-878-9000
Practice Address - Fax:510-564-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)