MEDICARE: SARA B ELMAHDI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194471417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA B ELMAHDI

Provider Business Mailing Address
First Line	:	3848 N 3RD AVE UNIT 1011
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3454
Country	:	US
Telephone Number	:	602-561-8104
Fax Number	:

Provider Business Practice Location Address
First Line	:	3848 N 3RD AVE UNIT 1011
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3454
Country	:	US
Telephone Number	:	602-561-8104
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2022
Last Update Date	:	05/26/2023

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Directions to “ SARA B ELMAHDI ” Practice Location

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