Provider Demographics
NPI:1689912149
Name:LEAP OF THE TRANSPOTATION, INC
Entity Type:Organization
Organization Name:LEAP OF THE TRANSPOTATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:ABDI
Authorized Official - Last Name:MOALLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-446-2438
Mailing Address - Street 1:3823 SULLIVAN AV
Mailing Address - Street 2:35
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228
Mailing Address - Country:US
Mailing Address - Phone:614-477-7275
Mailing Address - Fax:
Practice Address - Street 1:3823 SULLIVANT AVE
Practice Address - Street 2:35
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-2135
Practice Address - Country:US
Practice Address - Phone:614-477-7275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEAP OF THE TRANSPORTATION, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH259375343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)