Provider Demographics
NPI: | 1306667233 |
---|---|
Name: | TAJ CARE TARNSPORTATION LLC |
Entity type: | Organization |
Organization Name: | TAJ CARE TARNSPORTATION LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ONWER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | TAGASIR |
Authorized Official - Middle Name: | MOHAMED |
Authorized Official - Last Name: | OSMAN |
Authorized Official - Suffix: | SR |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 214-718-2301 |
Mailing Address - Street 1: | 701 E ALEXANDER LN |
Mailing Address - Street 2: | |
Mailing Address - City: | EULESS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 76040-8957 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 214-718-2301 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 701 E ALEXANDER LN |
Practice Address - Street 2: | |
Practice Address - City: | EULESS |
Practice Address - State: | TX |
Practice Address - Zip Code: | 76040-8957 |
Practice Address - Country: | US |
Practice Address - Phone: | 817-353-1744 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-10-23 |
Last Update Date: | 2024-10-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | |
No | 251T00000X | Agencies | Program of All-Inclusive Care for the Elderly (PACE) Provider Organization |