=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033019740
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WASIL MEDICAL TRANSPORTATION LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2026
-----------------------------------------------------
Last Update Date | 11/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1460 5TH ST # C5
-----------------------------------------------------
City | CORALVILLE
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52241-1804
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-383-2372
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1460 5TH ST
-----------------------------------------------------
City | CORALVILLE
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52241-1804
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-936-3570
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | OMER MOHAMED ELKHANGAR ELTAYEB
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 319-936-3570
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------