Provider Demographics
NPI:1700637634
Name:SUBURBAN COACH, INC
Entity type:Organization
Organization Name:SUBURBAN COACH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-284-1000
Mailing Address - Street 1:281 LEE BURBANK HWY
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-4061
Mailing Address - Country:US
Mailing Address - Phone:781-284-1000
Mailing Address - Fax:781-485-8800
Practice Address - Street 1:281 LEE BURBANK HWY
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-4061
Practice Address - Country:US
Practice Address - Phone:781-284-1000
Practice Address - Fax:781-485-8800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi