Healthcare Provider Details
I. General information
NPI: 1659112597
Provider Name (Legal Business Name): MINELIKE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2024
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11 PINE TREE DR
SHIRLEY NY
11967-4343
US
IV. Provider business mailing address
11 PINE TREE DR
SHIRLEY NY
11967-4343
US
V. Phone/Fax
- Phone: 631-989-9998
- Fax:
- Phone: 631-989-9998
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 344600000X |
| Taxonomy | Taxi |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347E00000X |
| Taxonomy | Transportation Broker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
HASSAN
ARIF
Title or Position: CEO
Credential:
Phone: 631-989-9998