Laith Abdalfattah Abuomran

Individual provider Active NPI Non-emergency Medical Transport (VAN) · Collierville, TN

NPI 1710537832 · NPPES record last updated Apr 3, 2025

Key facts

NPI
1710537832
Entity type
Individual (NPI type 1)
Primary specialty
Non-emergency Medical Transport (VAN) 343900000X
License
TXD718 (TN)
Practice address
514 Jeffrey LN
Collierville, TN 38017-1434
Phone
(540) 656-1393
NPI assigned
Sep 19, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
TXD718TNMDNon-emergency Medical Transport (VAN)
100037766VAMDPrivate Vehicle

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X 100037766 VA
Non-emergency Medical Transport (VAN) 343900000X TXD718 TN Yes

Addresses

Primary practice location

514 Jeffrey LN
Collierville, TN 38017-1434

Mailing address

514 Jeffrey LN
Collierville, TN 38017-1434
Phone (540) 656-1393

Other providers in Collierville, TN

All providers in Collierville, TN · Non-emergency Medical Transport (VAN) in Tennessee

Sources for this page

Verify at the official NPI Registry.