Provider Demographics
NPI:1427350065
Name:AIDMEDTRANS, LLC
Entity type:Organization
Organization Name:AIDMEDTRANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVLATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-577-8517
Mailing Address - Street 1:8432 FRANKLIN AVE
Mailing Address - Street 2:SUITE 18
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-5581
Mailing Address - Country:US
Mailing Address - Phone:800-577-8517
Mailing Address - Fax:515-727-2265
Practice Address - Street 1:8432 FRANKLIN AVE
Practice Address - Street 2:SUITE 18
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-5581
Practice Address - Country:US
Practice Address - Phone:800-577-8517
Practice Address - Fax:515-727-2265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAX000104089Medicaid