Provider Demographics
NPI:1912731860
Name:LIBERTY MED TRANSPORTATION INC
Entity type:Organization
Organization Name:LIBERTY MED TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZHORIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMERJYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-331-7808
Mailing Address - Street 1:13711 VAN NUYS BLVD UNIT 2D
Mailing Address - Street 2:
Mailing Address - City:PACOIMA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-3603
Mailing Address - Country:US
Mailing Address - Phone:747-331-7808
Mailing Address - Fax:747-788-4014
Practice Address - Street 1:13711 VAN NUYS BLVD UNIT 2D
Practice Address - Street 2:
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-3603
Practice Address - Country:US
Practice Address - Phone:747-331-7808
Practice Address - Fax:747-788-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)