Provider Demographics
NPI:1427523562
Name:HMEIDAN, SAHAR
Entity type:Individual
Prefix:
First Name:SAHAR
Middle Name:
Last Name:HMEIDAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PINK CAB EXPRESS, INC.
Mailing Address - Street 2:2221 P.O. BOX
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331
Mailing Address - Country:US
Mailing Address - Phone:248-954-7216
Mailing Address - Fax:
Practice Address - Street 1:36718 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3008
Practice Address - Country:US
Practice Address - Phone:248-954-7216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIH535758067437171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI47-3836363OtherLOGISTICARE