Provider Demographics
NPI:1861667271
Name:KOREN INCORPORATED DBA AGUILAS DOS MIL TAXI
Entity Type:Organization
Organization Name:KOREN INCORPORATED DBA AGUILAS DOS MIL TAXI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NIDIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KOREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-455-0060
Mailing Address - Street 1:3145 N 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85017-4805
Mailing Address - Country:US
Mailing Address - Phone:602-455-0060
Mailing Address - Fax:602-442-4617
Practice Address - Street 1:3145 N 33RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-4805
Practice Address - Country:US
Practice Address - Phone:602-455-0060
Practice Address - Fax:602-442-4617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBMF#15496344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi