Provider Demographics
NPI:1871176610
Name:PEACE TRANS
Entity type:Organization
Organization Name:PEACE TRANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KELIFA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ABDO
Authorized Official - Suffix:
Authorized Official - Credentials:PROVIDER
Authorized Official - Phone:702-215-1899
Mailing Address - Street 1:18112 MORETO LOOP
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5333
Mailing Address - Country:US
Mailing Address - Phone:702-215-1899
Mailing Address - Fax:
Practice Address - Street 1:18112 MORETO LOOP
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-5333
Practice Address - Country:US
Practice Address - Phone:702-215-1899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)