=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538854807
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERNEST ANDRE FRANKLIN TRANSPORTATION
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2023
-----------------------------------------------------
Last Update Date | 04/11/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3384 MARTIN LUTHER KING JR DR
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44104-5730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-356-7362
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3384 MARTIN LUTHER KING JR DR
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44104-5730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-356-7362
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number | RW124093
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------