Provider Demographics
NPI:1871946111
Name:W.S.A.M. TRANS & LIMO LLC
Entity type:Organization
Organization Name:W.S.A.M. TRANS & LIMO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WALID
Authorized Official - Middle Name:KHALID DAFAALA
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-273-9009
Mailing Address - Street 1:2058 N ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2961
Mailing Address - Country:US
Mailing Address - Phone:480-273-9009
Mailing Address - Fax:
Practice Address - Street 1:2058 N ARBOR LN
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2961
Practice Address - Country:US
Practice Address - Phone:480-273-9009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZE00463639343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)