Provider Demographics
NPI:1699457879
Name:ACE ROADSIDE ASSISTANCE INC
Entity type:Organization
Organization Name:ACE ROADSIDE ASSISTANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHANNAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDABOUQI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-421-9214
Mailing Address - Street 1:9100 AUTUMN SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3630
Mailing Address - Country:US
Mailing Address - Phone:661-421-9214
Mailing Address - Fax:
Practice Address - Street 1:9100 AUTUMN SUNSET DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3630
Practice Address - Country:US
Practice Address - Phone:661-421-9214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)