Healthcare Provider Details

I. General information

NPI: 1164816823
Provider Name (Legal Business Name): GOLDA-AMIT INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11919 TARRAGON RD, APT A
REISTERSTOWN MD
21136
US

IV. Provider business mailing address

11919 TARRAGON RD APT A
REISTERSTOWN MD
21136-3177
US

V. Phone/Fax

Practice location:
  • Phone: 443-739-7745
  • Fax:
Mailing address:
  • Phone: 443-739-7745
  • Fax: 888-259-1372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License NumberNS1309014
License Number StateMD

VIII. Authorized Official

Name: MR. PETER SAMSON SHITTA
Title or Position: PRESIDENT
Credential:
Phone: 443-739-7745