Provider Demographics
NPI:1942662325
Name:SELECTIVE NURSING LLC
Entity Type:Organization
Organization Name:SELECTIVE NURSING LLC
Other - Org Name:SELECTIVE TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:937-260-4250
Mailing Address - Street 1:2107 JERGENS RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404-1227
Mailing Address - Country:US
Mailing Address - Phone:937-260-4250
Mailing Address - Fax:
Practice Address - Street 1:2107 JERGENS RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1227
Practice Address - Country:US
Practice Address - Phone:937-260-4250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SELECTIVE NURSING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH575495343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)