Provider Demographics
NPI:1770717720
Name:AHMED, ORIT T
Entity type:Individual
Prefix:MISS
First Name:ORIT
Middle Name:T
Last Name:AHMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 W RIVER TRACE DR
Mailing Address - Street 2:#4
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2729
Mailing Address - Country:US
Mailing Address - Phone:901-336-5089
Mailing Address - Fax:901-372-5503
Practice Address - Street 1:2215 W RIVER TRACE DR
Practice Address - Street 2:#4
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-2729
Practice Address - Country:US
Practice Address - Phone:901-336-5089
Practice Address - Fax:901-372-5503
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN109002588343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)