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General NPI Number Information
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NPI Number | 1063709350
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Entity Type | Organization
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Legal Business Name | JACOB TRANSPORTATION INC
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 5052 N 35TH DR
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City | PHOENIX
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State | AZ
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Zip | 85019-2702
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Country | US
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Telephone | 602-866-7777
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Fax | 602-866-7786
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Provider Business Mailing Address
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Address Line | 5052 N 35 TH DR
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City | PHOENIX
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State | AZ
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Zip | 85019
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Country | US
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Telephone | 602-866-7777
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Fax | 602-866-7786
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Authorized Official
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Title or Position | OWNER/ PRESIDNET
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Name | MR. JACOB YOUSIF ABUALOKUL JR.
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Credential |
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Telephone | 602-866-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | 20141323
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 20141323
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License Number State | AZ
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