Healthcare Provider Details

I. General information

NPI: 1386580801
Provider Name (Legal Business Name): MAROLI MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11111 CUMPSTON ST APT 610
NORTH HOLLYWOOD CA
91601-6009
US

IV. Provider business mailing address

11111 CUMPSTON ST APT 610
NORTH HOLLYWOOD CA
91601-6009
US

V. Phone/Fax

Practice location:
  • Phone: 747-203-3327
  • Fax:
Mailing address:
  • Phone: 323-974-3945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: MR. EDUARD OVANESIAN
Title or Position: OPERATIONS PARTNER
Credential:
Phone: 323-974-3945