Provider Demographics
NPI:1437633021
Name:MID OHIO MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:MID OHIO MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GYEBI
Authorized Official - Suffix:
Authorized Official - Credentials:CLINICIAN
Authorized Official - Phone:614-843-7207
Mailing Address - Street 1:6161 BUSCH BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2508
Mailing Address - Country:US
Mailing Address - Phone:614-843-7207
Mailing Address - Fax:614-453-5818
Practice Address - Street 1:6161 BUSCH BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2508
Practice Address - Country:US
Practice Address - Phone:614-843-7207
Practice Address - Fax:614-453-5818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)