Provider Demographics
NPI:1073977906
Name:AE CARE SUPPORT
Entity Type:Organization
Organization Name:AE CARE SUPPORT
Other - Org Name:AECS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:ITANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-432-3039
Mailing Address - Street 1:120 NEWPORT CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6916
Mailing Address - Country:US
Mailing Address - Phone:949-432-3039
Mailing Address - Fax:
Practice Address - Street 1:120 NEWPORT CENTER DR
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-6916
Practice Address - Country:US
Practice Address - Phone:949-432-3039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker