Provider Demographics
NPI:1518849983
Name:ON TIME MEDICAL TRANSPORT SERVICES LLC
Entity type:Organization
Organization Name:ON TIME MEDICAL TRANSPORT SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISHRAGA
Authorized Official - Middle Name:ABDALLA
Authorized Official - Last Name:ABDULRAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-730-8800
Mailing Address - Street 1:520 W CENTURY AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5800
Mailing Address - Country:US
Mailing Address - Phone:602-517-6525
Mailing Address - Fax:855-500-0704
Practice Address - Street 1:1921 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-2427
Practice Address - Country:US
Practice Address - Phone:480-730-8800
Practice Address - Fax:866-404-4647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ474559Medicaid