Provider Demographics
NPI:1144765314
Name:PATRICK JUBILEE LLC
Entity Type:Organization
Organization Name:PATRICK JUBILEE LLC
Other - Org Name:TRANS-MEDICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:AGBOMERE
Authorized Official - Last Name:OGEDENGBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-308-7265
Mailing Address - Street 1:5902 LARAMIE RIVER CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-1718
Mailing Address - Country:US
Mailing Address - Phone:832-934-4943
Mailing Address - Fax:
Practice Address - Street 1:5902 LARAMIE RIVER CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-1718
Practice Address - Country:US
Practice Address - Phone:832-934-4943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)