Provider Demographics
NPI:1316409824
Name:NICKINC DBA CARX
Entity type:Organization
Organization Name:NICKINC DBA CARX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEELUM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOONDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-251-6773
Mailing Address - Street 1:1400 BELL ISLAND TRL
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7463
Mailing Address - Country:US
Mailing Address - Phone:410-251-6773
Mailing Address - Fax:
Practice Address - Street 1:1400 BELL ISLAND TRL
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7463
Practice Address - Country:US
Practice Address - Phone:410-251-6773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)