Provider Demographics
NPI:1679266670
Name:FIRST LINE TRANSPORTATION
Entity Type:Organization
Organization Name:FIRST LINE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:915-309-4735
Mailing Address - Street 1:5500 S MARGINAL RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-1073
Mailing Address - Country:US
Mailing Address - Phone:915-309-4735
Mailing Address - Fax:
Practice Address - Street 1:5500 S MARGINAL RD STE 210
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-1073
Practice Address - Country:US
Practice Address - Phone:915-309-4735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)