Provider Demographics
NPI:1023332152
Name:SAFETY ONE MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:SAFETY ONE MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDELGABAR
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:MOHAMDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-217-1559
Mailing Address - Street 1:8528 N 43RD DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-5302
Mailing Address - Country:US
Mailing Address - Phone:623-217-1559
Mailing Address - Fax:
Practice Address - Street 1:8528 N 43RD DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-5302
Practice Address - Country:US
Practice Address - Phone:623-217-1559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAFETY ONE MEDICAL TRANSPORTATION CO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4763363416L0300X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No3416L0300XTransportation ServicesAmbulanceLand Transport