Healthcare Provider Details

I. General information

NPI: 1891622924
Provider Name (Legal Business Name): CASSIDY'S TRANSPORT SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 BROUGHTON PL
RIVERSIDE OH
45431-1148
US

IV. Provider business mailing address

5002 BROUGHTON PL
RIVERSIDE OH
45431-1148
US

V. Phone/Fax

Practice location:
  • Phone: 937-668-1109
  • Fax:
Mailing address:
  • Phone: 937-668-1109
  • 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: MR. MICHAEL CASSIDY
Title or Position: OWNER/OPERATOR
Credential:
Phone: 937-668-1109