Provider Demographics
NPI:1013412030
Name:OKINE, ENOCH
Entity Type:Individual
Prefix:
First Name:ENOCH
Middle Name:
Last Name:OKINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6090 POPES CREEK PL
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-5430
Mailing Address - Country:US
Mailing Address - Phone:571-274-1975
Mailing Address - Fax:
Practice Address - Street 1:6090 POPES CREEK PL
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-5430
Practice Address - Country:US
Practice Address - Phone:571-274-1975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle