Provider Demographics
NPI:1437717527
Name:PREFERRED SENIOR TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:PREFERRED SENIOR TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOHSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-239-4385
Mailing Address - Street 1:9335 ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-9643
Mailing Address - Country:US
Mailing Address - Phone:937-239-4385
Mailing Address - Fax:
Practice Address - Street 1:9335 ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:OH
Practice Address - Zip Code:45309-9643
Practice Address - Country:US
Practice Address - Phone:937-239-4385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0294810Medicaid