Healthcare Provider Details

I. General information

NPI: 1013481365
Provider Name (Legal Business Name): PBC TRANSPORTATION & HAULING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2019
Last Update Date: 01/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 WHITBY RD
CLEVELAND HEIGHTS OH
44112-2348
US

IV. Provider business mailing address

950 WHITBY RD
CLEVELAND HEIGHTS OH
44112-2348
US

V. Phone/Fax

Practice location:
  • Phone: 216-334-0494
  • Fax:
Mailing address:
  • Phone: 216-334-0494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. TERRELL CLIFF GARDNER
Title or Position: OWNER/CEO
Credential: DET, SUMMA CUM LAUDE
Phone: 216-334-0494