Provider Demographics
NPI:1326553918
Name:RAINBOW MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:RAINBOW MEDICAL TRANSPORTATION LLC
Other - Org Name:RAINBOW MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:SAMAN
Authorized Official - Last Name:BARRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-295-5669
Mailing Address - Street 1:3540 GEORGETOWN CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40215-1604
Mailing Address - Country:US
Mailing Address - Phone:502-294-4665
Mailing Address - Fax:
Practice Address - Street 1:3540 GEORGETOWN CIR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1604
Practice Address - Country:US
Practice Address - Phone:502-294-4665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA07594913343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY=========Medicaid