Provider Demographics
NPI:1679197032
Name:SAMIC LLC
Entity type:Organization
Organization Name:SAMIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REMILEKUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEBOLATAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-480-3203
Mailing Address - Street 1:6026 HACKBERRY BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2945
Mailing Address - Country:US
Mailing Address - Phone:346-313-3509
Mailing Address - Fax:
Practice Address - Street 1:6026 HACKBERRY BRANCH LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2945
Practice Address - Country:US
Practice Address - Phone:346-313-3509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)