Provider Demographics
NPI:1659860344
Name:ATHENS GO TO CAB
Entity Type:Organization
Organization Name:ATHENS GO TO CAB
Other - Org Name:ATHENS AMBULETTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KERBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-331-1718
Mailing Address - Street 1:52 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-1649
Mailing Address - Country:US
Mailing Address - Phone:740-331-1718
Mailing Address - Fax:740-249-4078
Practice Address - Street 1:52 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1649
Practice Address - Country:US
Practice Address - Phone:740-331-1718
Practice Address - Fax:740-249-4078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)