Provider Demographics
NPI:1093119430
Name:METRO CAB OF GRAND RAPIDS
Entity Type:Organization
Organization Name:METRO CAB OF GRAND RAPIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-946-1718
Mailing Address - Street 1:24957 BREST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-4027
Mailing Address - Country:US
Mailing Address - Phone:734-946-1708
Mailing Address - Fax:
Practice Address - Street 1:4678 DANVERS DR SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49512-4019
Practice Address - Country:US
Practice Address - Phone:616-957-1835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi