Provider Demographics
NPI:1578829701
Name:SHIBO TRANS CORP
Entity Type:Organization
Organization Name:SHIBO TRANS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDELRAHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-583-6707
Mailing Address - Street 1:111 S HARRISON ST
Mailing Address - Street 2:SUITE 612
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1726
Mailing Address - Country:US
Mailing Address - Phone:973-583-6707
Mailing Address - Fax:973-547-9142
Practice Address - Street 1:111 S HARRISON ST
Practice Address - Street 2:SUITE 612
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1726
Practice Address - Country:US
Practice Address - Phone:973-583-6707
Practice Address - Fax:973-547-9142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1212072Medicaid