Healthcare Provider Details

I. General information

NPI: 1659084432
Provider Name (Legal Business Name): LD TRANSPORTATION SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2022
Last Update Date: 12/27/2022
Certification Date: 12/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 MELODYMANOR DR
CINCINNATI OH
45239-5455
US

IV. Provider business mailing address

3375 MELODYMANOR DR
CINCINNATI OH
45239-5455
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-0884
  • Fax:
Mailing address:
  • Phone: 513-861-0884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateNULL

VIII. Authorized Official

Name: LASHAUNA DENISE DAVIS
Title or Position: MANAGER
Credential:
Phone: 513-806-4339