Provider Demographics
NPI:1629888524
Name:SELAMTA TRANSPORT LLC
Entity type:Organization
Organization Name:SELAMTA TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAKACHEW
Authorized Official - Middle Name:M
Authorized Official - Last Name:BIZUAYEHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-556-7374
Mailing Address - Street 1:8747 NOLAND RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3433
Mailing Address - Country:US
Mailing Address - Phone:206-556-7374
Mailing Address - Fax:
Practice Address - Street 1:8747 NOLAND RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3433
Practice Address - Country:US
Practice Address - Phone:206-556-7374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SELAMTA TRANSPORT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)