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NPI Code Detail

MEDICARE: LIFE LONG TRANSPORTATION LLC

MEDICARE: LIFE LONG TRANSPORTATION LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1770932964
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE LONG TRANSPORTATION LLC
Provider Business Mailing Address
First Line : 390 DEEP CREEK CIRCLE
Second Line :
City : NORTHFIELD
State : OH
Zip : 44067
Country : US
Telephone Number : 216-410-5707
Fax Number :
Provider Business Practice Location Address
First Line : 17325 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44112-1247
Country : US
Telephone Number : 216-491-1701
Fax Number : 216-452-0613
Authorized Official
Title or Position : OWNER
Name : RICHARD SHURNEY
Credential :
Telephone Number : 216-491-1701
Provider Enumeration Date : 06/08/2016
Last Update Date : 02/28/2018

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Directions to “LIFE LONG TRANSPORTATION LLC ” Practice Location

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