Provider Demographics
NPI:1962615583
Name:JIHAD PROPERTIES TRANSPORTATION SVC LLC
Entity type:Organization
Organization Name:JIHAD PROPERTIES TRANSPORTATION SVC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER,OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-409-3026
Mailing Address - Street 1:1509 SHADY GLEN DR
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1747
Mailing Address - Country:US
Mailing Address - Phone:202-409-3026
Mailing Address - Fax:
Practice Address - Street 1:1509 SHADY GLEN DR
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-1747
Practice Address - Country:US
Practice Address - Phone:202-409-3026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC514630506399343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)