Provider Demographics
NPI:1891029906
Name:SOUTHERN OHIO TRANSIT SERVICE, LLC
Entity Type:Organization
Organization Name:SOUTHERN OHIO TRANSIT SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHAD
Authorized Official - Middle Name:E
Authorized Official - Last Name:WOOTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-574-2800
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-0116
Mailing Address - Country:US
Mailing Address - Phone:740-574-2800
Mailing Address - Fax:740-574-2131
Practice Address - Street 1:8046 OHIO RIVER RD STE D
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-1689
Practice Address - Country:US
Practice Address - Phone:740-574-2800
Practice Address - Fax:740-574-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
OHN/A344600000X
OH347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi