=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851090393
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILES OF LOVE TRANSPORTATION LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/23/2023
-----------------------------------------------------
Last Update Date | 02/23/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13706 BEACHWOOD AVE
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44105-6424
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-287-7229
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13706 BEACHWOOD AVE
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44105-6424
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-287-7229
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. CRAIG GARNER II
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 216-287-7229
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------