Provider Demographics
NPI:1760006589
Name:LORDESS CARE AND MEDTRANS LLC
Entity Type:Organization
Organization Name:LORDESS CARE AND MEDTRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN JOSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:AYUKETAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-522-9990
Mailing Address - Street 1:11260 LEANDER CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-2206
Mailing Address - Country:US
Mailing Address - Phone:513-552-9990
Mailing Address - Fax:513-772-8547
Practice Address - Street 1:11500 SPRINGFIELD PIKE UNIT A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3500
Practice Address - Country:US
Practice Address - Phone:513-552-9990
Practice Address - Fax:513-772-8547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health