Provider Demographics
NPI:1285837666
Name:SAFEWAY TRANSPORTATION,INC.
Entity Type:Organization
Organization Name:SAFEWAY TRANSPORTATION,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LILITA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSELMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-581-9077
Mailing Address - Street 1:23660 MILES RD #105
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128
Mailing Address - Country:US
Mailing Address - Phone:216-581-9077
Mailing Address - Fax:216-581-8974
Practice Address - Street 1:23660 MILES RD #105
Practice Address - Street 2:
Practice Address - City:BEDFORD HTS
Practice Address - State:OH
Practice Address - Zip Code:44128
Practice Address - Country:US
Practice Address - Phone:216-581-9077
Practice Address - Fax:216-581-8974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH200305203238343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========Medicaid