Provider Demographics
NPI:1760918197
Name:OHIO MEDICAL TRANSPORTATION NON-EMERGENCY LLC
Entity Type:Organization
Organization Name:OHIO MEDICAL TRANSPORTATION NON-EMERGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAVARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-516-9095
Mailing Address - Street 1:PO BOX 328735
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-8735
Mailing Address - Country:US
Mailing Address - Phone:614-516-9095
Mailing Address - Fax:
Practice Address - Street 1:2445 MASON VILLAGE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-8239
Practice Address - Country:US
Practice Address - Phone:614-516-9095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)