Provider Demographics
NPI:1174667414
Name:ATLANTIC MEDICAL TRANSPORTAION
Entity Type:Organization
Organization Name:ATLANTIC MEDICAL TRANSPORTAION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-531-9666
Mailing Address - Street 1:5241 WILSON MILLS RD STE 26
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2142
Mailing Address - Country:US
Mailing Address - Phone:216-849-7464
Mailing Address - Fax:
Practice Address - Street 1:5241 WILSON MILLS RD STE 26
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2142
Practice Address - Country:US
Practice Address - Phone:216-849-7464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2384478343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)