Provider Demographics
NPI:1588495055
Name:EAGLE MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:EAGLE MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BESMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAKU
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:203-725-5660
Mailing Address - Street 1:358 FRENCH ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-2911
Mailing Address - Country:US
Mailing Address - Phone:203-725-5660
Mailing Address - Fax:
Practice Address - Street 1:120 KISCO AVE
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1415
Practice Address - Country:US
Practice Address - Phone:203-725-5660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)