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General NPI Number Information
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NPI Number | 1881043719
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Entity Type | Organization
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Legal Business Name | WABASH ESTATES, LP
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 532 ABELSON DR
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City | CARMI
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State | IL
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Zip | 62821-1588
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Country | US
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Telephone | 618-382-2900
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Fax | 618-382-8067
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Provider Business Mailing Address
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Address Line | 532 ABELSON DR
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City | CARMI
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State | IL
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Zip | 62821-1588
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Country | US
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Telephone | 618-382-2900
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Fax | 618-382-8067
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. SUSAN MCGHEE
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Credential |
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Telephone | 314-587-7903
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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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