Provider Demographics
NPI:1932545712
Name:COMMUNITY EXPRESS
Entity Type:Organization
Organization Name:COMMUNITY EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAYMUNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:YUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-377-4747
Mailing Address - Street 1:3890 WINBERIE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-8343
Mailing Address - Country:US
Mailing Address - Phone:614-377-4747
Mailing Address - Fax:
Practice Address - Street 1:3890 WINBERIE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-8343
Practice Address - Country:US
Practice Address - Phone:614-377-4747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3154009Medicaid