Provider Demographics
NPI:1063033710
Name:SMAG GROUP
Entity Type:Organization
Organization Name:SMAG GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AFOLABI
Authorized Official - Middle Name:TAOFEEK
Authorized Official - Last Name:GIWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-254-2377
Mailing Address - Street 1:13099 WESTHEIMER RD APT 2401
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5581
Mailing Address - Country:US
Mailing Address - Phone:281-741-7411
Mailing Address - Fax:
Practice Address - Street 1:2500 WILCREST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-2752
Practice Address - Country:US
Practice Address - Phone:347-245-2377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle