Provider Demographics
NPI:1154212124
Name:IC CAB LLC
Entity type:Organization
Organization Name:IC CAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF DEVELOPMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TATE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-905-8249
Mailing Address - Street 1:PO BOX 6878
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0924
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 MARKET ST STE 324
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2872
Practice Address - Country:US
Practice Address - Phone:304-905-8249
Practice Address - Fax:304-905-8251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi