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General NPI Number Information
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NPI Number | 1558837526
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Entity Type | Organization
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Legal Business Name | SMART CAB LLC
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Dates
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Enumeration Date | 10/17/2018
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Last Update Date | 10/17/2018
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Provider Practice Location Address
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Address Line | 7584 OLIVE BLVD STE 206
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City | SAINT LOUIS
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State | MO
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Zip | 63130-1600
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Country | US
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Telephone | 314-833-3288
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Fax | 314-833-3280
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Provider Business Mailing Address
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Address Line | 7584 OLIVE BLVD STE 206
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City | SAINT LOUIS
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State | MO
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Zip | 63130-1600
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Country | US
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Telephone | 314-833-3288
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Fax | 314-833-3280
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Authorized Official
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Title or Position | GENERAL OPERATION MANAGER
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Name | TEKLETSADIK BEKELE YEDEMDEM
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Credential |
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Telephone | 314-680-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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