Provider Demographics
NPI:1578171195
Name:WEEMS-SHOLANKE, SAIYDAH (RN)
Entity Type:Individual
Prefix:
First Name:SAIYDAH
Middle Name:
Last Name:WEEMS-SHOLANKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AMS
Other - Middle Name:
Other - Last Name:TRANSPORT LLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1579 EDGEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2846
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1579 EDGEFIELD RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2846
Practice Address - Country:US
Practice Address - Phone:440-681-0532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH172A00000X
172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0405845Medicaid