Provider Demographics
NPI:1821603044
Name:PRECIOUS ANGEL TRANSPORTATION
Entity Type:Organization
Organization Name:PRECIOUS ANGEL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCONAHAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-601-0345
Mailing Address - Street 1:P.O. BOX 1679
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691
Mailing Address - Country:US
Mailing Address - Phone:330-601-0345
Mailing Address - Fax:
Practice Address - Street 1:5751 TR 258
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654-4465
Practice Address - Country:US
Practice Address - Phone:330-231-1996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)