Healthcare Provider Details

I. General information

NPI: 1578499117
Provider Name (Legal Business Name): HIRA MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4503 PINECREST HEIGHTS DR
ANNANDALE VA
22003-3534
US

IV. Provider business mailing address

9480 MAIN ST # 1116
FAIRFAX VA
22031-4032
US

V. Phone/Fax

Practice location:
  • Phone: 571-866-0561
  • Fax:
Mailing address:
  • Phone: 571-866-0561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MUCHEYE ACHENEF AYALEW
Title or Position: MR
Credential:
Phone: 571-866-0561