Provider Demographics
NPI:1629154414
Name:CLC TRANSPORTATION INC.
Entity Type:Organization
Organization Name:CLC TRANSPORTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BIEVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-241-0112
Mailing Address - Street 1:103 S BEDFORD RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3440
Mailing Address - Country:US
Mailing Address - Phone:914-241-0112
Mailing Address - Fax:914-241-0886
Practice Address - Street 1:103 S BEDFORD RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3440
Practice Address - Country:US
Practice Address - Phone:914-241-0112
Practice Address - Fax:914-241-0886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01361095343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01361095Medicaid