Provider Demographics
NPI: | 1851507164 |
---|---|
Name: | TRIUMPH INVALID COACH |
Entity Type: | Organization |
Organization Name: | TRIUMPH INVALID COACH |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ASIM |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | ABDELMAGIED |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | TRANSPORTATION |
Authorized Official - Phone: | 201-646-9020 |
Mailing Address - Street 1: | 299 W FORT LEE RD # 202 |
Mailing Address - Street 2: | |
Mailing Address - City: | BOGOTA |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 07603-1288 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 201-646-9020 |
Mailing Address - Fax: | 201-646-9770 |
Practice Address - Street 1: | 299 W FORT LEE RD # 202 |
Practice Address - Street 2: | |
Practice Address - City: | BOGOTA |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 07603-1288 |
Practice Address - Country: | US |
Practice Address - Phone: | 201-646-9020 |
Practice Address - Fax: | 201-646-9770 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-05-15 |
Last Update Date: | 2008-07-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 6981003 | 343900000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) |