Provider Demographics
NPI:1407961501
Name:MITCHEN'S TRANSPORTATION SERVICE INC
Entity Type:Organization
Organization Name:MITCHEN'S TRANSPORTATION SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MITCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-836-3485
Mailing Address - Street 1:175 SOUTHWEST AVE
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-2230
Mailing Address - Country:US
Mailing Address - Phone:330-836-3485
Mailing Address - Fax:330-873-3022
Practice Address - Street 1:175 SOUTHWEST AVE
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2230
Practice Address - Country:US
Practice Address - Phone:330-836-3485
Practice Address - Fax:330-873-3022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH770122341600000X
OH775015343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2633261Medicaid
OH9358761Medicare ID - Type Unspecified