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General NPI Number Information
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NPI Number | 1336914837
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Entity Type | Organization
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Legal Business Name | SHALASH MEDICAL TRANSPORTATION LLC
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Dates
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Enumeration Date | 11/15/2023
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 6449 W GLENDALE AVE
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City | GLENDALE
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State | AZ
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Zip | 85301-2310
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Country | US
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Telephone | 614-271-0330
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Fax |
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Provider Business Mailing Address
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Address Line | 1920 W KINFIELD TRL
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City | PHOENIX
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State | AZ
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Zip | 85085-8674
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Country | US
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Telephone | 614-271-0330
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HUSAM SHALASH
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Credential |
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Telephone | 614-271-0330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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