Provider Demographics
NPI:1700445517
Name:AL JABRI, BASSIM B
Entity Type:Individual
Prefix:
First Name:BASSIM
Middle Name:B
Last Name:AL JABRI
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 1:370 NEFF AVE STE P
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3246
Mailing Address - Country:US
Mailing Address - Phone:804-764-8494
Mailing Address - Fax:
Practice Address - Street 1:1128 PAUL REVERE CT
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-6521
Practice Address - Country:US
Practice Address - Phone:540-435-4546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA660022454021Medicaid