Healthcare Provider Details

I. General information

NPI: 1609504331
Provider Name (Legal Business Name): PONNIE'S RELIABLE TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13520 WOODWARD BLVD
CLEVELAND OH
44125-6035
US

IV. Provider business mailing address

13520 WOODWARD BLVD
CLEVELAND OH
44125-6035
US

V. Phone/Fax

Practice location:
  • Phone: 216-396-9764
  • Fax:
Mailing address:
  • Phone: 216-396-9764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MALCOLM TERRY
Title or Position: AGENT
Credential:
Phone: 216-396-9764