Healthcare Provider Details

I. General information

NPI: 1023739976
Provider Name (Legal Business Name): AYA CARE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 SOUTHSIDE DR STE 115
SALEM VA
24153-4652
US

IV. Provider business mailing address

1390 SOUTHSIDE DR STE 115
SALEM VA
24153-4652
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-0192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AZIZA KHALIL
Title or Position: OWNER
Credential:
Phone: 434-200-0192