Provider Demographics
NPI:1396192605
Name:C.H. MEDICAL TRANSPORTATION INC
Entity Type:Organization
Organization Name:C.H. MEDICAL TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:IBRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-271-4340
Mailing Address - Street 1:PO BOX 77079
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-8079
Mailing Address - Country:US
Mailing Address - Phone:585-271-4340
Mailing Address - Fax:
Practice Address - Street 1:871 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-1716
Practice Address - Country:US
Practice Address - Phone:585-271-4340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02339435Medicaid