Provider Demographics
NPI:1417353715
Name:PRIMCARE TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:PRIMCARE TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARLITA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-281-1951
Mailing Address - Street 1:644 LONGFELLOW DR
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-1127
Mailing Address - Country:US
Mailing Address - Phone:216-801-8134
Mailing Address - Fax:440-243-5162
Practice Address - Street 1:644 LONGFELLOW DR
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-1127
Practice Address - Country:US
Practice Address - Phone:216-801-8134
Practice Address - Fax:440-243-5162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)