Healthcare Provider Details

I. General information

NPI: 1508453812
Provider Name (Legal Business Name): ALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2020
Last Update Date: 12/22/2020
Certification Date: 12/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8370 RAVENNA RD
CONCORD TWP OH
44077-9386
US

IV. Provider business mailing address

8370 RAVENNA RD
CONCORD TWP OH
44077-9386
US

V. Phone/Fax

Practice location:
  • Phone: 440-478-5070
  • Fax:
Mailing address:
  • Phone: 440-478-5070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: AARON SUYDAM
Title or Position: OWNER/CEO
Credential:
Phone: 440-478-5070