Provider Demographics
NPI:1710743620
Name:EBENEZER OPERATIONS INC.
Entity Type:Organization
Organization Name:EBENEZER OPERATIONS INC.
Other - Org Name:RAPHARIDE TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:UTOMWEN
Authorized Official - Middle Name:TESSY
Authorized Official - Last Name:AIKPITANYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-347-2228
Mailing Address - Street 1:213 DARLINGTON TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76131-3583
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 GRASSY VIEW DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-7550
Practice Address - Country:US
Practice Address - Phone:682-347-2228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)