Provider Demographics
NPI:1720359573
Name:IC GROUP INC
Entity Type:Organization
Organization Name:IC GROUP INC
Other - Org Name:IC MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SARFARAZ
Authorized Official - Middle Name:HASAN
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-403-4501
Mailing Address - Street 1:3130 NEW HAMPSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-8312
Mailing Address - Country:US
Mailing Address - Phone:951-403-4501
Mailing Address - Fax:951-905-5417
Practice Address - Street 1:3130 NEW HAMPSHIRE DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-8312
Practice Address - Country:US
Practice Address - Phone:951-403-4501
Practice Address - Fax:951-905-5417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)