Healthcare Provider Details

I. General information

NPI: 1811586167
Provider Name (Legal Business Name): BYRDIE'S TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5242 WARRENSVILLE CENTER RD
MAPLE HEIGHTS OH
44137
US

IV. Provider business mailing address

16781 CHAGRIN BLVD BOX #104
SHAKER HEIGHTS OH
44120-3721
US

V. Phone/Fax

Practice location:
  • Phone: 216-816-5778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MORGAN JACKSON
Title or Position: AUTHORIZED OFFICIAL/CFO/PARTNER
Credential:
Phone: 216-632-3425