Healthcare Provider Details

I. General information

NPI: 1639613458
Provider Name (Legal Business Name): SALIMA TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2016
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12412 MONROE AVE
GRANDVIEW MO
64030-1529
US

IV. Provider business mailing address

1101 HAMPTON DR
RAYMORE MO
64083-8340
US

V. Phone/Fax

Practice location:
  • Phone: 913-206-3476
  • Fax:
Mailing address:
  • Phone: 913-206-3476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number2016/02
License Number StateMO

VIII. Authorized Official

Name: MOHAMMED M BENKHADRA
Title or Position: OWNER
Credential:
Phone: 913-206-3476