Provider Demographics
NPI:1497040158
Name:SERVING IN EXCELLENCE TRANSPORTATION SERVICE
Entity Type:Organization
Organization Name:SERVING IN EXCELLENCE TRANSPORTATION SERVICE
Other - Org Name:SIE TRANSPORTATION SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER, SERVICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-938-8993
Mailing Address - Street 1:3709 HILDANA RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-5005
Mailing Address - Country:US
Mailing Address - Phone:216-938-8993
Mailing Address - Fax:216-862-6459
Practice Address - Street 1:3709 HILDANA RD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120-5005
Practice Address - Country:US
Practice Address - Phone:216-938-8993
Practice Address - Fax:216-862-6459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH188095343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2999902Medicaid