Provider Demographics
NPI:1346018744
Name:BENEVOLENCE TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:BENEVOLENCE TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:
Authorized Official - Last Name:EADDIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-203-7387
Mailing Address - Street 1:3523 WOODRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44121-1533
Mailing Address - Country:US
Mailing Address - Phone:216-203-7387
Mailing Address - Fax:
Practice Address - Street 1:675 ALPHA DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2139
Practice Address - Country:US
Practice Address - Phone:216-203-7387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)