Healthcare Provider Details

I. General information

NPI: 1679867840
Provider Name (Legal Business Name): ENTERPRISE MEDICALERVICES TRANSPORTATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6522 LIMPKIN DR
COLUMBUS OH
43230-6472
US

IV. Provider business mailing address

6522 LIMPKIN DR
COLUMBUS OH
43230-6472
US

V. Phone/Fax

Practice location:
  • Phone: 614-560-1848
  • Fax:
Mailing address:
  • Phone: 614-560-1848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. KIDEST KIFLE
Title or Position: OWNER
Credential:
Phone: 614-560-1848