Healthcare Provider Details

I. General information

NPI: 1407405285
Provider Name (Legal Business Name): KETTERING TRANSPORTATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 NICHOLAS RD
DAYTON OH
45417-6713
US

IV. Provider business mailing address

1050 FORRER BLVD STE 110
KETTERING OH
45420-1472
US

V. Phone/Fax

Practice location:
  • Phone: 937-762-5919
  • Fax:
Mailing address:
  • Phone: 937-762-5919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ANDY HILL
Title or Position: DIRECTOR
Credential:
Phone: 937-762-5934