Provider Demographics
NPI:1922856251
Name:CONCORD ENTERPRISE CORP
Entity type:Organization
Organization Name:CONCORD ENTERPRISE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-943-2152
Mailing Address - Street 1:PO BOX 797
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-0797
Mailing Address - Country:US
Mailing Address - Phone:510-943-2152
Mailing Address - Fax:
Practice Address - Street 1:31263 LILY ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-2641
Practice Address - Country:US
Practice Address - Phone:510-943-2152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)