Provider Demographics
NPI:1174130132
Name:CORALVILLE PROFESSIONAL SERVICES PLC
Entity type:Organization
Organization Name:CORALVILLE PROFESSIONAL SERVICES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:FILALI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD MBA
Authorized Official - Phone:319-248-5535
Mailing Address - Street 1:1840 S GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-4340
Mailing Address - Country:US
Mailing Address - Phone:319-248-5535
Mailing Address - Fax:319-519-6083
Practice Address - Street 1:1840 S GILBERT ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4340
Practice Address - Country:US
Practice Address - Phone:319-248-5535
Practice Address - Fax:319-519-6083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriverGroup - Single Specialty
No347E00000XTransportation ServicesTransportation Broker