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General NPI Number Information
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NPI Number | 1639702855
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Entity Type | Organization
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Legal Business Name | OHIO WELLNESS TRANSIT
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Dates
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Enumeration Date | 02/17/2020
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 3295 W. 97TH ST
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City | CLEVELAND
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State | OH
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Zip | 44102
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Country | US
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Telephone | 330-327-1180
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Fax |
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Provider Business Mailing Address
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Address Line | 3295 W. 97TH ST
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City | CLEVELAND
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State | OH
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Zip | 44102
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Country | US
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Telephone | 330-327-1180
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. MARK J PELLEGRINO
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Credential | MD
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Telephone | 330-327-1180
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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 |
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License Number State |
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