Provider Demographics
NPI:1770916199
Name:JEMERIGBE, PETER ENOJAINE (MSCE, PE, PMP)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:ENOJAINE
Last Name:JEMERIGBE
Suffix:
Gender:M
Credentials:MSCE, PE, PMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 692562
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95269-2562
Mailing Address - Country:US
Mailing Address - Phone:209-918-0918
Mailing Address - Fax:
Practice Address - Street 1:7 W ACACIA ST
Practice Address - Street 2:SUITE 3D
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-1243
Practice Address - Country:US
Practice Address - Phone:209-918-0918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)