Healthcare Provider Details

I. General information

NPI: 1992558779
Provider Name (Legal Business Name): AMERICAN EAGLE TRANSPORTATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2024
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3511 KARIKAL DR
WESTERVILLE OH
43081-4024
US

IV. Provider business mailing address

3511 KARIKAL DR
WESTERVILLE OH
43081-4024
US

V. Phone/Fax

Practice location:
  • Phone: 919-797-8757
  • Fax:
Mailing address:
  • Phone: 919-797-8757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: ESTABRAQ ALSAADI
Title or Position: ADMINATRATOR
Credential:
Phone: 919-797-8757