Provider Demographics
NPI:1437321981
Name:HOWARD, JIMMIE CORNELL
Entity Type:Individual
Prefix:MR
First Name:JIMMIE
Middle Name:CORNELL
Last Name:HOWARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11345 DEQUINDRE ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-2923
Mailing Address - Country:US
Mailing Address - Phone:313-449-6411
Mailing Address - Fax:313-826-1934
Practice Address - Street 1:11345 DEQUINDRE ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-2923
Practice Address - Country:US
Practice Address - Phone:313-449-6411
Practice Address - Fax:313-826-1934
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)