Provider Demographics
NPI:1487390175
Name:ISRAEL, AMMIYHUD (OWNER)
Entity type:Individual
Prefix:
First Name:AMMIYHUD
Middle Name:
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8650 15 MILE RD APT A
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-3671
Mailing Address - Country:US
Mailing Address - Phone:586-554-6007
Mailing Address - Fax:
Practice Address - Street 1:8650 15 MILE RD APT A
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-3671
Practice Address - Country:US
Practice Address - Phone:586-554-6007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No253Z00000XAgenciesIn Home Supportive Care
No342000000XTransportation ServicesTransportation Network Company