Healthcare Provider Details

I. General information

NPI: 1316401573
Provider Name (Legal Business Name): JACOB CAR SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 JACKSON ST SUITE 2 L
YONKERS NY
10701-4795
US

IV. Provider business mailing address

71 JACKSON ST SUITE 2 L
YONKERS NY
10701-4795
US

V. Phone/Fax

Practice location:
  • Phone: 914-512-6235
  • Fax:
Mailing address:
  • Phone: 914-512-6235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: PRINCE JAMMIE
Title or Position: DIRECTOR
Credential:
Phone: 914-512-6235