Provider Demographics
NPI:1043968738
Name:AZHALA MEDICARE TRANSPORTATION LLC
Entity type:Organization
Organization Name:AZHALA MEDICARE TRANSPORTATION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:N/A
Authorized Official - Prefix:
Authorized Official - First Name:ABRHA
Authorized Official - Middle Name:KAHSAY
Authorized Official - Last Name:ABRHA
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:512-566-9881
Mailing Address - Street 1:530 BUCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5701
Mailing Address - Country:US
Mailing Address - Phone:512-566-9881
Mailing Address - Fax:
Practice Address - Street 1:530 BUCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5701
Practice Address - Country:US
Practice Address - Phone:512-566-9881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-12
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)