Provider Demographics
NPI:1639355589
Name:BUCKEYES MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:BUCKEYES MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMUD
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-352-0945
Mailing Address - Street 1:2151 E DUBLIN GRANVILLE RD STE 207
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3519
Mailing Address - Country:US
Mailing Address - Phone:614-523-3389
Mailing Address - Fax:614-523-3759
Practice Address - Street 1:2151 E DUBLIN GRANVILLE RD STE 207
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3519
Practice Address - Country:US
Practice Address - Phone:614-523-3389
Practice Address - Fax:614-523-3759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2773262Medicaid