Provider Demographics
NPI:1598094641
Name:FRIENDLY TOUCH MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:FRIENDLY TOUCH MEDICAL TRANSPORTATION LLC
Other - Org Name:FRIENDLY TOUCH MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-254-2134
Mailing Address - Street 1:10323 EMPIRE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-2833
Mailing Address - Country:US
Mailing Address - Phone:216-254-2134
Mailing Address - Fax:216-249-3646
Practice Address - Street 1:10323 EMPIRE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-2833
Practice Address - Country:US
Practice Address - Phone:216-254-2134
Practice Address - Fax:216-249-3646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18-803-5343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2988601Medicaid