Healthcare Provider Details
I. General information
NPI: 1275010191
Provider Name (Legal Business Name): COSIVA TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/24/2018
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23334 WILLIAMS AVE
EUCLID OH
44123-1525
US
IV. Provider business mailing address
23334 WILLIAMS AVE
EUCLID OH
44123-1525
US
V. Phone/Fax
- Phone: 216-233-1820
- Fax: 216-472-8162
- Phone: 216-233-1820
- Fax: 216-472-8162
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | OH |
VIII. Authorized Official
Name: MS.
SHEREE
LAVETTE
STARR
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 216-233-1820