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
| License | State | Type | Specialty |
|---|---|---|---|
| TXD718 | TN | MD | Non-emergency Medical Transport (VAN) |
| 100037766 | VA | MD | Private Vehicle |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Access Home Health Care Agency,LLC
- Access Medical Supply & Delivery
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- Carly Taylor Adams
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All providers in Collierville, TN · Non-emergency Medical Transport (VAN) in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.