Provider Demographics
NPI:1558820068
Name:CAMELOT TRANSPORTATION LLC
Entity Type:Organization
Organization Name:CAMELOT TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OSIZEMETE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKPETU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-769-7785
Mailing Address - Street 1:28202 CABOT RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1249
Mailing Address - Country:US
Mailing Address - Phone:614-769-7785
Mailing Address - Fax:
Practice Address - Street 1:28202 CABOT RD STE 300
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1249
Practice Address - Country:US
Practice Address - Phone:614-769-7785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)