MEDICARE: DEENA INVALID COACH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	7727003	NJ

General Provider Information

NPI Number	:	1154533594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEENA INVALID COACH, INC.

Provider Business Mailing Address
First Line	:	520 WESTFIELD AVE
Second Line	:	202A
City	:	ELIZABETH
State	:	NJ
Zip	:	07208-1658
Country	:	US
Telephone Number	:	908-353-1989
Fax Number	:	908-353-0036

Provider Business Practice Location Address
First Line	:	520 WESTFIELD AVE
Second Line	:	202A
City	:	ELIZABETH
State	:	NJ
Zip	:	07208-1658
Country	:	US
Telephone Number	:	908-353-1989
Fax Number	:	908-353-0036

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MERGHANI M. ALI
Credential	:
Telephone Number	:	973-417-1634

Provider Enumeration Date	:	05/06/2007
Last Update Date	:	08/22/2020

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