Provider Demographics
NPI:1417468711
Name:MACWHEELS LLC
Entity Type:Organization
Organization Name:MACWHEELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CONKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-806-1335
Mailing Address - Street 1:3186 CARIE HILL CIR NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-2377
Mailing Address - Country:US
Mailing Address - Phone:330-806-7941
Mailing Address - Fax:
Practice Address - Street 1:3186 CARIE HILL CIR NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-2377
Practice Address - Country:US
Practice Address - Phone:330-806-7941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH747YZP343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)