Provider Demographics
NPI:1225326531
Name:SAFEWAY NON-EMERGENCY MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:SAFEWAY NON-EMERGENCY MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTUR
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGORYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-339-1010
Mailing Address - Street 1:5301 LAUREL CANYON BLVD SUIT 250
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-2736
Mailing Address - Country:US
Mailing Address - Phone:818-764-8000
Mailing Address - Fax:818-787-1887
Practice Address - Street 1:5301 LAUREL CANYON BLVD SUIT 250
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-2736
Practice Address - Country:US
Practice Address - Phone:818-764-8000
Practice Address - Fax:818-787-1887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)