Provider Demographics
NPI:1407728496
Name:ACHIMBI DOE, HUMPHREY
Entity type:Individual
Prefix:
First Name:HUMPHREY
Middle Name:
Last Name:ACHIMBI DOE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6037 DEVONSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-3516
Mailing Address - Country:US
Mailing Address - Phone:717-343-7920
Mailing Address - Fax:
Practice Address - Street 1:6037 DEVONSHIRE RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-3516
Practice Address - Country:US
Practice Address - Phone:717-343-7920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-19
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
347E00000X
PA33148028347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker