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General NPI Number Information
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NPI Number | 1154212124
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Entity Type | Organization
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Legal Business Name | IC CAB LLC
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 500 MARKET ST STE 324
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City | STEUBENVILLE
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State | OH
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Zip | 43952-2872
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Country | US
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Telephone | 304-905-8249
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Fax | 304-905-8251
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Provider Business Mailing Address
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Address Line | PO BOX 6878
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City | WHEELING
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State | WV
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Zip | 26003-0924
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF DEVELOPMENT DIRECTOR
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Name | TATE BLANCHARD
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Credential |
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Telephone | 304-905-8249
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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 |
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License Number State |
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