Provider Demographics
NPI:1669284436
Name:MORAD MED TRANS LLC
Entity type:Organization
Organization Name:MORAD MED TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HOZIFA
Authorized Official - Middle Name:
Authorized Official - Last Name:IBRAHIM OMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-842-6561
Mailing Address - Street 1:14830 N BLACK CANYON HWY APT 2033
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-4944
Mailing Address - Country:US
Mailing Address - Phone:646-842-6561
Mailing Address - Fax:
Practice Address - Street 1:14830 N BLACK CANYON HWY APT 2033
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-4944
Practice Address - Country:US
Practice Address - Phone:646-842-6561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)