Organization
COACHTRAVEL SERVICE
Active
Organization
COACHTRAVEL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MILIME ELIEN (OWNER)
(973) 214-2419
Entity
Organization
Contact information
Practice address
554 BLOOMFIELD AVENUE, SUITE 2C, BLOOMFIELD, NJ 07003
(973) 748-1698
Mailing address
554 BLOOMFIELD AVENUE, SUITE 2C, BLOOMFIELD, NJ 07003
(973) 748-1698
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
COAC00135
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7758901
—
NJ
Enumeration date
05/03/2007
Last updated
07/14/2008
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