Provider Demographics
NPI:1558483651
Name:VICEROY TRANSPORTATION LTD
Entity Type:Organization
Organization Name:VICEROY TRANSPORTATION LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZAKARI
Authorized Official - Middle Name:Y
Authorized Official - Last Name:UMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-394-1621
Mailing Address - Street 1:20291 LINDA DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-2420
Mailing Address - Country:US
Mailing Address - Phone:216-394-1621
Mailing Address - Fax:216-539-4268
Practice Address - Street 1:20291 LINDA DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-2420
Practice Address - Country:US
Practice Address - Phone:216-394-1621
Practice Address - Fax:216-539-4268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2708627Medicaid