Provider Demographics
NPI:1558459586
Name:CANAL TRANSPORT CORPORATION
Entity Type:Organization
Organization Name:CANAL TRANSPORT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-865-0098
Mailing Address - Street 1:1557 WOOSTER AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-4061
Mailing Address - Country:US
Mailing Address - Phone:330-865-0098
Mailing Address - Fax:330-865-9820
Practice Address - Street 1:1557 WOOSTER AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4061
Practice Address - Country:US
Practice Address - Phone:330-865-0098
Practice Address - Fax:330-865-9820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2396750Medicaid