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General NPI Number Information
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NPI Number | 1194179507
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Entity Type | Organization
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Legal Business Name | SAND EXPRESS TRANSPORTATION, LLC
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Dates
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Enumeration Date | 04/21/2016
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Last Update Date | 04/21/2016
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Provider Practice Location Address
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Address Line | 1733 DUNLAP DR
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City | STREETSBORO
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State | OH
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Zip | 44241-5186
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Country | US
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Telephone | 330-554-0296
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Fax |
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Provider Business Mailing Address
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Address Line | 1733 DUNLAP DR
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City | STREETSBORO
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State | OH
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Zip | 44241-5186
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Country | US
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Telephone | 330-554-0296
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CASSANDRA SANDERS
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Credential |
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Telephone | 216-849-5935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 675095
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License Number State | OH
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