Provider Demographics
NPI:1851507164
Name:TRIUMPH INVALID COACH
Entity type:Organization
Organization Name:TRIUMPH INVALID COACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASIM
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABDELMAGIED
Authorized Official - Suffix:
Authorized Official - Credentials:TRANSPORTATION
Authorized Official - Phone:201-646-9020
Mailing Address - Street 1:299 W FORT LEE RD # 202
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1288
Mailing Address - Country:US
Mailing Address - Phone:201-646-9020
Mailing Address - Fax:201-646-9770
Practice Address - Street 1:299 W FORT LEE RD # 202
Practice Address - Street 2:
Practice Address - City:BOGOTA
Practice Address - State:NJ
Practice Address - Zip Code:07603-1288
Practice Address - Country:US
Practice Address - Phone:201-646-9020
Practice Address - Fax:201-646-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ6981003343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)