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General NPI Number Information
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NPI Number | 1598770398
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Entity Type | Organization
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Legal Business Name | ABLE MEDICAL TRANSPORT OF SOUTHERN OHIO LLC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 03/21/2013
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Provider Practice Location Address
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Address Line | 8046 OHIO RIVER RD STE B
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City | WHEELERSBURG
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State | OH
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Zip | 45694-1689
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Country | US
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Telephone | 740-574-5555
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Fax | 740-574-2790
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Provider Business Mailing Address
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Address Line | PO BOX 315
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City | WHEELERSBURG
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State | OH
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Zip | 45694-0315
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Country | US
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Telephone | 740-574-5555
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Fax | 740-574-2790
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | SHAD E WOOTEN
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Credential |
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Telephone | 740-574-5555
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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 | 735135
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 730182
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License Number State | OH
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