Provider Demographics
NPI:1568060036
Name:MARHABA TRANSPORT SERVICE
Entity Type:Organization
Organization Name:MARHABA TRANSPORT SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C E O
Authorized Official - Prefix:MR
Authorized Official - First Name:NURUDEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNIRU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-427-4680
Mailing Address - Street 1:4414 N LOCKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-2353
Mailing Address - Country:US
Mailing Address - Phone:718-427-4680
Mailing Address - Fax:
Practice Address - Street 1:4414 N LOCKWOOD AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-2353
Practice Address - Country:US
Practice Address - Phone:718-427-4680
Practice Address - Fax:419-213-8603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0408969Medicaid