Provider Demographics
NPI:1710554928
Name:FOUR LEAF LIQUIDATORS
Entity Type:Organization
Organization Name:FOUR LEAF LIQUIDATORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-715-5705
Mailing Address - Street 1:8550 DRUMMOND DR NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-9536
Mailing Address - Country:US
Mailing Address - Phone:133-071-5570
Mailing Address - Fax:
Practice Address - Street 1:8550 DRUMMOND DR NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9536
Practice Address - Country:US
Practice Address - Phone:133-071-5570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)