Provider Demographics
NPI:1740818251
Name:ICARE CAB
Entity type:Organization
Organization Name:ICARE CAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZIMIYBELU
Authorized Official - Middle Name:BEYENE
Authorized Official - Last Name:LAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-503-1250
Mailing Address - Street 1:2613 HILLIARD RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-4524
Mailing Address - Country:US
Mailing Address - Phone:804-503-1250
Mailing Address - Fax:
Practice Address - Street 1:2613 HILLIARD RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-4524
Practice Address - Country:US
Practice Address - Phone:804-503-1250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-30
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)