Individual
IBRAHIM IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7070 CAPITOL CT APT 857, OMAHA, NE 68132-2766
(402) 321-3648
Mailing address
7070 CAPITOL CT APT 857, OMAHA, NE 68132-2766
(402) 321-3648
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-2692325
—
IA
Enumeration date
02/26/2020
Last updated
02/26/2020
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