Provider Demographics
NPI:1558799056
Name:ACADEMY TAXI SERVICE
Entity Type:Organization
Organization Name:ACADEMY TAXI SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOURGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-722-2111
Mailing Address - Street 1:12450 INDEPENDENCE CT APT A5
Mailing Address - Street 2:
Mailing Address - City:PRINCESS ANNE
Mailing Address - State:MD
Mailing Address - Zip Code:21853-3022
Mailing Address - Country:US
Mailing Address - Phone:443-722-2111
Mailing Address - Fax:
Practice Address - Street 1:12450 INDEPENDENCE CT APT A5
Practice Address - Street 2:
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21853-3022
Practice Address - Country:US
Practice Address - Phone:443-722-2111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDB620785298002344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi