Provider Demographics
NPI:1407057094
Name:AMERICAN RIDE & WHEELCHAIR COACH
Entity Type:Organization
Organization Name:AMERICAN RIDE & WHEELCHAIR COACH
Other - Org Name:CHARLENE P AUGUSTINE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:AUGUSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-276-1700
Mailing Address - Street 1:1368 W 65 ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-6120
Mailing Address - Country:US
Mailing Address - Phone:216-276-1700
Mailing Address - Fax:440-779-1826
Practice Address - Street 1:1368 W 65 ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-6120
Practice Address - Country:US
Practice Address - Phone:216-276-1700
Practice Address - Fax:440-779-1826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2432684Medicaid