Provider Demographics
NPI:1982246146
Name:MARE TRANSPORTATION
Entity Type:Organization
Organization Name:MARE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GETAHUN
Authorized Official - Middle Name:ASSEFA
Authorized Official - Last Name:TECHANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-655-1326
Mailing Address - Street 1:4001 CAMBRIAN CIR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-5023
Mailing Address - Country:US
Mailing Address - Phone:804-655-1326
Mailing Address - Fax:
Practice Address - Street 1:4001 CAMBRIAN CIR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-5023
Practice Address - Country:US
Practice Address - Phone:804-655-1329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)