Provider Demographics
NPI:1407022239
Name:DOC TRANSPORTATION CORP
Entity Type:Organization
Organization Name:DOC TRANSPORTATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DELMARR
Authorized Official - Middle Name:O
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:216-240-0314
Mailing Address - Street 1:11811 SHAKER BLVD
Mailing Address - Street 2:SUITE 316
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1931
Mailing Address - Country:US
Mailing Address - Phone:216-721-4353
Mailing Address - Fax:216-721-4363
Practice Address - Street 1:11811 SHAKER BLVD
Practice Address - Street 2:SUITE 316
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1931
Practice Address - Country:US
Practice Address - Phone:216-721-4353
Practice Address - Fax:216-721-4363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2510009Medicaid