Healthcare Provider Details

I. General information

NPI: 1972297331
Provider Name (Legal Business Name): AA CABBIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 SIOUX ST
SIOUX CITY IA
51103
US

IV. Provider business mailing address

615 SIOUX ST
SIOUX CITY IA
51103
US

V. Phone/Fax

Practice location:
  • Phone: 712-252-5259
  • Fax: 712-252-5259
Mailing address:
  • Phone: 712-252-5259
  • Fax: 712-252-5259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: AMANDA JOHNSON
Title or Position: MANAGER
Credential:
Phone: 712-252-5259