Provider Demographics
NPI:1114750981
Name:SAFE PASS MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:SAFE PASS MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALKACHOURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-576-8144
Mailing Address - Street 1:4747 BROOKS ST STE A
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-4728
Mailing Address - Country:US
Mailing Address - Phone:909-576-8144
Mailing Address - Fax:909-766-2995
Practice Address - Street 1:4747 BROOKS ST STE A
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-4728
Practice Address - Country:US
Practice Address - Phone:909-576-8144
Practice Address - Fax:909-766-2995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)