Provider Demographics
NPI:1790324507
Name:INFINITY MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:INFINITY MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LILIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VOVK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-421-9066
Mailing Address - Street 1:5332 SEBASTIAN CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1941
Mailing Address - Country:US
Mailing Address - Phone:440-421-9066
Mailing Address - Fax:440-683-1671
Practice Address - Street 1:5332 SEBASTIAN CT
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1941
Practice Address - Country:US
Practice Address - Phone:440-421-9066
Practice Address - Fax:440-683-1671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2500823Medicaid