Provider Demographics
NPI:1023359502
Name:ENRICH MEDICAL TRANSOPORTATION
Entity Type:Organization
Organization Name:ENRICH MEDICAL TRANSOPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:MOHAMUD
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MECHANICAL ENGINEER
Authorized Official - Phone:419-322-5824
Mailing Address - Street 1:1041 ANSONIA ST
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3114
Mailing Address - Country:US
Mailing Address - Phone:419-322-5824
Mailing Address - Fax:
Practice Address - Street 1:1041 ANSONIA ST
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616
Practice Address - Country:US
Practice Address - Phone:419-322-5824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSS471142343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)