=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821569609
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ENSURE TRANSPORTATION SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2018
-----------------------------------------------------
Last Update Date | 12/05/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 858 SALINA ST
-----------------------------------------------------
City | EL CAJON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92020-6441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-654-8974
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 858 SALINA ST
-----------------------------------------------------
City | EL CAJON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92020-6441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-654-8974
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. MOHAMMED AL HADEETHI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 508-654-8974
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------