Provider Demographics
NPI:1992172738
Name:FARAH, IBRAHIM M
Entity type:Individual
Prefix:MR
First Name:IBRAHIM
Middle Name:M
Last Name:FARAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 MURFREESBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2213
Mailing Address - Country:US
Mailing Address - Phone:615-361-5369
Mailing Address - Fax:615-360-0866
Practice Address - Street 1:1130 MURFREESBORO PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2213
Practice Address - Country:US
Practice Address - Phone:615-361-5369
Practice Address - Fax:615-360-0866
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)