Provider Demographics
NPI:1285393595
Name:SUDA CARE LLC
Entity type:Organization
Organization Name:SUDA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SALEH
Authorized Official - Middle Name:ISHAG SALEH
Authorized Official - Last Name:BAROUKH
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:336-456-1560
Mailing Address - Street 1:3341 W DRAKE ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2317
Mailing Address - Country:US
Mailing Address - Phone:336-456-1560
Mailing Address - Fax:
Practice Address - Street 1:3341 W DRAKE ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-2317
Practice Address - Country:US
Practice Address - Phone:336-456-1560
Practice Address - Fax:602-437-0171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)