Provider Demographics
NPI:1982822854
Name:STATUS INVALID COACH SERVICES
Entity Type:Organization
Organization Name:STATUS INVALID COACH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESEDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:A
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-780-9577
Mailing Address - Street 1:PO BOX 17378
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-7378
Mailing Address - Country:US
Mailing Address - Phone:201-864-2224
Mailing Address - Fax:201-864-2235
Practice Address - Street 1:71 QUARRY ST
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1914
Practice Address - Country:US
Practice Address - Phone:201-864-2224
Practice Address - Fax:201-864-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSTAT00550343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)