Healthcare Provider Details

I. General information

NPI: 1225128507
Provider Name (Legal Business Name): GREATHOUSE MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3937 ELMWOOD RD
CLEVELAND HEIGHTS OH
44121-2432
US

IV. Provider business mailing address

3937 ELMWOOD RD
CLEVELAND HEIGHTS OH
44121-2432
US

V. Phone/Fax

Practice location:
  • Phone: 216-383-8826
  • Fax: 216-382-8831
Mailing address:
  • Phone: 216-383-8826
  • Fax: 216-382-8831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberRU784914
License Number StateOH

VIII. Authorized Official

Name: CHRISTINE GREATHOUSE
Title or Position: OWNER/DRIVER
Credential:
Phone: 216-383-8826