Healthcare Provider Details

I. General information

NPI: 1568634111
Provider Name (Legal Business Name): SHAFI MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2008
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2819 HILLIARD ROAD #L
RICHMOND VA
23228
US

IV. Provider business mailing address

PO BOX 9612
ROCHMOND VA
23228
US

V. Phone/Fax

Practice location:
  • Phone: 804-874-2736
  • Fax: 804-266-4881
Mailing address:
  • Phone: 804-874-2796
  • Fax: 804-266-4881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. HASSAN ADAM KHAMIS
Title or Position: PRESIDENT
Credential:
Phone: 804-874-2736