Healthcare Provider Details

I. General information

NPI: 1194422758
Provider Name (Legal Business Name): TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 EUCLID AVE APT 808
CLEVELAND OH
44115-2152
US

IV. Provider business mailing address

1600 EUCLID AVE APT 808
CLEVELAND OH
44115-2152
US

V. Phone/Fax

Practice location:
  • Phone: 216-334-4928
  • Fax:
Mailing address:
  • Phone: 216-334-4928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CORY LEE WASHINGTON JR.
Title or Position: CEO
Credential:
Phone: 216-334-4928