Provider Demographics
NPI:1528698420
Name:ANDROMACH CORPORATION
Entity type:Organization
Organization Name:ANDROMACH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAJID
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-331-8878
Mailing Address - Street 1:9250 RESEDA BLVD UNIT 232
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-3142
Mailing Address - Country:US
Mailing Address - Phone:818-941-5359
Mailing Address - Fax:800-549-3846
Practice Address - Street 1:7625 RESEDA BLVD UNIT 105
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-7401
Practice Address - Country:US
Practice Address - Phone:818-941-5359
Practice Address - Fax:800-549-3846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)