Provider Demographics
NPI:1679638704
Name:SECURE CARE TRANSPORTATION GROUP, LLC.
Entity Type:Organization
Organization Name:SECURE CARE TRANSPORTATION GROUP, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:PITEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-486-0700
Mailing Address - Street 1:5075 TAYLOR DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5456
Mailing Address - Country:US
Mailing Address - Phone:216-486-0700
Mailing Address - Fax:
Practice Address - Street 1:5075 TAYLOR DR
Practice Address - Street 2:SUITE 1
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5456
Practice Address - Country:US
Practice Address - Phone:216-486-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH180082341600000X
OH186135343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered341600000XTransportation ServicesAmbulance
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2390550Medicaid
OH=========004OtherMEDICAL MUTUAL
OH22025Medicare UPIN
OH9332811Medicare ID - Type Unspecified