Healthcare Provider Details

I. General information

NPI: 1215854260
Provider Name (Legal Business Name): VAN-GO MEDICAL TRANSPORT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7402 PRESLEY AVE
MENTOR OH
44060-5751
US

IV. Provider business mailing address

7402 PRESLEY AVE
MENTOR OH
44060-5751
US

V. Phone/Fax

Practice location:
  • Phone: 440-478-6283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY MYERS
Title or Position: MANAGER
Credential:
Phone: 440-478-6283