Provider Demographics
NPI:1831968072
Name:OPHIR LLC
Entity type:Organization
Organization Name:OPHIR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEKLIT
Authorized Official - Middle Name:
Authorized Official - Last Name:GEBRELUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-862-8253
Mailing Address - Street 1:8620 PARK LN APT 1018
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-6886
Mailing Address - Country:US
Mailing Address - Phone:214-862-8253
Mailing Address - Fax:
Practice Address - Street 1:8620 PARK LN
Practice Address - Street 2:1018
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-6886
Practice Address - Country:US
Practice Address - Phone:214-862-8253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)