Provider Demographics
NPI:1548776743
Name:SUPREME LIMOUSINE LLC
Entity Type:Organization
Organization Name:SUPREME LIMOUSINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-682-8063
Mailing Address - Street 1:504 MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2984
Mailing Address - Country:US
Mailing Address - Phone:860-284-0508
Mailing Address - Fax:860-284-0519
Practice Address - Street 1:504 MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2984
Practice Address - Country:US
Practice Address - Phone:860-284-0508
Practice Address - Fax:860-284-0519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-26
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTP-2515347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker