Provider Demographics
NPI:1659738144
Name:CAMERON TRANSPORT CARPET CLEANING
Entity Type:Organization
Organization Name:CAMERON TRANSPORT CARPET CLEANING
Other - Org Name:CAMERON TRANSPORT CORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAISEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-371-0960
Mailing Address - Street 1:2901 PINE AVE REAR
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-2443
Mailing Address - Country:US
Mailing Address - Phone:716-371-0960
Mailing Address - Fax:716-371-0962
Practice Address - Street 1:2901 PINE AVE REAR
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-2443
Practice Address - Country:US
Practice Address - Phone:716-371-0960
Practice Address - Fax:716-371-0962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257382209344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04275701Medicaid