Provider Demographics
NPI:1013216464
Name:LIFEQUEST TRANSPORTATION,LLC
Entity Type:Organization
Organization Name:LIFEQUEST TRANSPORTATION,LLC
Other - Org Name:LIFEQUEST TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JENOVA
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MCLELLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-638-8620
Mailing Address - Street 1:2063 ELMORE AVENUE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224
Mailing Address - Country:US
Mailing Address - Phone:614-638-8620
Mailing Address - Fax:614-532-0226
Practice Address - Street 1:2063 ELMORE AVENUE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224
Practice Address - Country:US
Practice Address - Phone:614-638-8620
Practice Address - Fax:614-532-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)