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General NPI Number Information
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NPI Number | 1669962114
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Entity Type | Organization
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Legal Business Name | CISSE ENTERPRISE LLC
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 3112 BALSAMRIDGE DR
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City | CINCINNATI
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State | OH
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Zip | 45239-7102
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Country | US
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Telephone | 513-602-4526
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11215
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City | CINCINNATI
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State | OH
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Zip | 45211-0215
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Country | US
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Telephone | 513-602-4526
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BOUBA CISSE
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Credential |
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Telephone | 513-487-9940
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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 | 638
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License Number State | OH
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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 |
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License Number State |
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