Provider Demographics
NPI:1598796914
Name:TRINITY MEDICAL TRANSPORT INC.
Entity Type:Organization
Organization Name:TRINITY MEDICAL TRANSPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:937-418-1987
Mailing Address - Street 1:40 KESTREL CT
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-4511
Mailing Address - Country:US
Mailing Address - Phone:937-773-5613
Mailing Address - Fax:937-773-5613
Practice Address - Street 1:40 KESTREL CT
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-4511
Practice Address - Country:US
Practice Address - Phone:937-773-5613
Practice Address - Fax:937-773-5613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH550082341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2404080Medicaid
OH9332841Medicare ID - Type Unspecified