Provider Demographics
NPI:1306557806
Name:MARIE MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:MARIE MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DHERGANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:506-708-5638
Mailing Address - Street 1:5600 ALEXIS RD APT 170
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2332
Mailing Address - Country:US
Mailing Address - Phone:206-708-5638
Mailing Address - Fax:419-214-0180
Practice Address - Street 1:5600 ALEXIS RD APT 170
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2332
Practice Address - Country:US
Practice Address - Phone:206-708-5638
Practice Address - Fax:419-214-0180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi