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General NPI Number Information
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NPI Number | 1700397155
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Entity Type | Organization
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Legal Business Name | MICROBASE COMMUNICATIONS INC
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 692 BLUE RIDGE DR
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City | MEDFORD
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State | NY
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Zip | 11763-1213
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Country | US
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Telephone | 631-860-8889
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Fax | 631-860-8889
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Provider Business Mailing Address
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Address Line | 1488 DEER PARK AVE # 329
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City | NORTH BABYLON
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State | NY
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Zip | 11703-1208
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Country | US
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Telephone | 631-860-8889
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | SHOLA T JOHNSON
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Credential |
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Telephone | 631-860-8889
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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 | NY
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