Provider Demographics
NPI:1447089867
Name:LUCKY CARE MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:LUCKY CARE MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYEE
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCKY
Authorized Official - Middle Name:ABDULLAH
Authorized Official - Last Name:BRAIMAH
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:510-395-7196
Mailing Address - Street 1:1900 POWELL ST
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1811
Mailing Address - Country:US
Mailing Address - Phone:510-395-7196
Mailing Address - Fax:
Practice Address - Street 1:3021 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-3659
Practice Address - Country:US
Practice Address - Phone:510-395-7196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)