Provider Demographics
NPI:1205594041
Name:ISSOUFOU GARBA, RAMATOU (LLC)
Entity type:Individual
Prefix:
First Name:RAMATOU
Middle Name:
Last Name:ISSOUFOU GARBA
Suffix:
Gender:F
Credentials:LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 PLEASANT MEADOW BLVD APT B
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4982
Mailing Address - Country:US
Mailing Address - Phone:330-283-6427
Mailing Address - Fax:
Practice Address - Street 1:380 PLEASANT MEADOW BLVD APT B
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4982
Practice Address - Country:US
Practice Address - Phone:330-283-6427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)