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General NPI Number Information
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NPI Number | 1760991285
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Entity Type | Organization
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Legal Business Name | A.B.R.A.M. INC.
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 6751 S EMERALD AVE
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City | CHICAGO
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State | IL
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Zip | 60621-2509
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Country | US
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Telephone | 773-488-2887
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 21904 6751 SO. EMERALD
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City | CHICAGO
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State | IL
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Zip | 60621-2509
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Country | US
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Telephone | 773-488-2887
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Fax |
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Authorized Official
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Title or Position | DIRECTOR & PRESIDENT
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Name | MR. DARON ANTHONY WASHINGTON
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Credential | PH. T
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Telephone | 773-488-2887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | W252-1617-3197
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 333300000X
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Taxonomy Name | Emergency Response System Companies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 049122123
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License Number State | IL
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