1720254550 NPI number — TRANS MOBALE EXPRESS INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720254550 NPI number — TRANS MOBALE EXPRESS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRANS MOBALE EXPRESS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TRANS MOBILE EXPRESS
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720254550
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24569 FRAMINGHAM DR
Provider Second Line Business Mailing Address:
24569 FRAMINGHAM DRIVE
Provider Business Mailing Address City Name:
WESTLAKE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44145-4903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-390-9990
Provider Business Mailing Address Fax Number:
440-777-4362

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24569 FRAMINGHAM DR
Provider Second Line Business Practice Location Address:
24569 FRAMINGHAM DRIVE
Provider Business Practice Location Address City Name:
WESTLAKE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44145-4903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-390-9990
Provider Business Practice Location Address Fax Number:
440-777-4362
Provider Enumeration Date:
05/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MUNTASER
Authorized Official First Name:
ADEL
Authorized Official Middle Name:
MANSOUR
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
216-390-9990

Provider Taxonomy Codes

  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2709340 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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