Provider Demographics
NPI:1164909958
Name:AAA TRANSPORT LLC
Entity Type:Organization
Organization Name:AAA TRANSPORT LLC
Other - Org Name:AAA TRANSPORT LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NUUR
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-554-3948
Mailing Address - Street 1:3621 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-2911
Mailing Address - Country:US
Mailing Address - Phone:614-532-8119
Mailing Address - Fax:614-532-8319
Practice Address - Street 1:3621 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-2911
Practice Address - Country:US
Practice Address - Phone:614-532-8119
Practice Address - Fax:614-532-8319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0280032Medicaid