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General NPI Number Information
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NPI Number | 1134734759
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Entity Type | Organization
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Legal Business Name | AMISTAD HERITAGE LLC
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Dates
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Enumeration Date | 09/10/2020
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | 17325 EUCLID AVE STE 2007
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City | CLEVELAND
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State | OH
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Zip | 44112-1250
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Country | US
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Telephone | 216-346-0472
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 ORANGE AVENUE, PO BOX 94053
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City | CLEVELAND
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State | OH
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Zip | 44101
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Country | US
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Telephone | 216-346-4072
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. PETER A ADALIKWU
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Credential |
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Telephone | 216-346-4072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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