Provider Demographics
NPI:1346715026
Name:NEW AGE TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:NEW AGE TRANSPORTATION, LLC
Other - Org Name:NEW AGE TRANS UNLIMITED DBA NEW AGE TRANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:LAVETTE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DELEGATED OFFICIAL
Authorized Official - Phone:216-334-8348
Mailing Address - Street 1:1276 HIRD AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3023
Mailing Address - Country:US
Mailing Address - Phone:216-334-8348
Mailing Address - Fax:216-712-4861
Practice Address - Street 1:1276 HIRD AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-3023
Practice Address - Country:US
Practice Address - Phone:216-334-8348
Practice Address - Fax:216-712-4861
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW AGE TRANS UNLIMITED DBA NEW AGE TRANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-09
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)