Healthcare Provider Details

I. General information

NPI: 1336779438
Provider Name (Legal Business Name): C2 TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2020
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4091 LINCOLN AVE
SHADYSIDE OH
43947-1234
US

IV. Provider business mailing address

4091 LINCOLN AVE
SHADYSIDE OH
43947-1234
US

V. Phone/Fax

Practice location:
  • Phone: 740-921-8922
  • Fax:
Mailing address:
  • Phone: 855-371-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL E ROBINSON JR.
Title or Position: PRESIDENT
Credential:
Phone: 855-371-0022