Provider Demographics
NPI:1376756734
Name:RIVER NILE INVALID COACH INC.
Entity Type:Organization
Organization Name:RIVER NILE INVALID COACH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHALILAH
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-414-9112
Mailing Address - Street 1:34 PROSPECT ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-2323
Mailing Address - Country:US
Mailing Address - Phone:973-414-9112
Mailing Address - Fax:
Practice Address - Street 1:34 PROSPECT ST
Practice Address - Street 2:SUITE 6
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-2323
Practice Address - Country:US
Practice Address - Phone:973-414-9112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ67546013416L0300X
NJ343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3416L0300XTransportation ServicesAmbulanceLand Transport
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6754601Medicaid