Provider Demographics
NPI:1801676424
Name:WHITE ANGELS TRANSPORTATION, LLC
Entity type:Organization
Organization Name:WHITE ANGELS TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AMER
Authorized Official - Middle Name:
Authorized Official - Last Name:ISKHARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-495-6577
Mailing Address - Street 1:56291 BIRKDALE DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-1131
Mailing Address - Country:US
Mailing Address - Phone:248-688-6219
Mailing Address - Fax:586-372-9680
Practice Address - Street 1:56291 BIRKDALE DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-1131
Practice Address - Country:US
Practice Address - Phone:248-688-6219
Practice Address - Fax:586-372-9680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)