Provider Demographics
NPI:1275531170
Name:L.J.LEWIS ENTERPRISES, INC
Entity Type:Organization
Organization Name:L.J.LEWIS ENTERPRISES, INC
Other - Org Name:ACTION AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:POPADAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-369-3600
Mailing Address - Street 1:421 SOUTH ST SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-5719
Mailing Address - Country:US
Mailing Address - Phone:330-369-3600
Mailing Address - Fax:330-395-0110
Practice Address - Street 1:421 SOUTH ST SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-5719
Practice Address - Country:US
Practice Address - Phone:330-369-3600
Practice Address - Fax:330-395-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH780012341600000X, 3416L0300X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000155679OtherANTHEM
OH0698044Medicaid
OH9226957Medicare ID - Type Unspecified