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General NPI Number Information
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NPI Number | 1770936569
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Entity Type | Organization
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Legal Business Name | SHALOM TRANSPORTATION
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Dates
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Enumeration Date | 07/18/2016
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Last Update Date | 07/18/2016
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Provider Practice Location Address
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Address Line | 468 W HERNDON AVE
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City | FRESNO
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State | CA
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Zip | 93650-1361
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Country | US
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Telephone | 559-287-5642
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Fax |
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Provider Business Mailing Address
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Address Line | 6653 N PIMA AVE
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City | FRESNO
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State | CA
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Zip | 93722-9782
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Country | US
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Telephone | 559-287-5642
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Fax | 559-438-0352
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Authorized Official
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Title or Position | OWNER
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Name | ZOGRAB TSOLOKIAN
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Credential | PARTNER
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Telephone | 559-287-5642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 70222Z1
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License Number State | CA
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