Provider Demographics
NPI:1306159793
Name:WAAMO MEDICAL TRANSPORTATION, LLC
Entity type:Organization
Organization Name:WAAMO MEDICAL TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BASHEIR
Authorized Official - Middle Name:W
Authorized Official - Last Name:ELMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-679-0020
Mailing Address - Street 1:4040 E MCDOWELL RD
Mailing Address - Street 2:STE# 405
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-4414
Mailing Address - Country:US
Mailing Address - Phone:602-679-0020
Mailing Address - Fax:
Practice Address - Street 1:4040 E MCDOWELL RD
Practice Address - Street 2:STE# 405
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4414
Practice Address - Country:US
Practice Address - Phone:602-679-0020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)