Provider Demographics
NPI:1043502040
Name:MIRE, ADEN
Entity type:Individual
Prefix:
First Name:ADEN
Middle Name:
Last Name:MIRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6740 HUNTLEY RD
Mailing Address - Street 2:SUIT 107
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1064
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6740 HUNTLEY RD
Practice Address - Street 2:SUIT 107
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1064
Practice Address - Country:US
Practice Address - Phone:614-804-8521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH451766349343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)