Provider Demographics
NPI:1730466046
Name:CAPITAL CITY SERVICES LLC
Entity Type:Organization
Organization Name:CAPITAL CITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:JELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-596-1007
Mailing Address - Street 1:3435 WESTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224
Mailing Address - Country:US
Mailing Address - Phone:614-596-1007
Mailing Address - Fax:614-453-8712
Practice Address - Street 1:3435 WESTERVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224
Practice Address - Country:US
Practice Address - Phone:614-596-1007
Practice Address - Fax:614-453-8712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHFJW6453343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0051141Medicaid
OH2557862OtherDODD CONTRACT NUMBER