Provider Demographics
NPI:1013520089
Name:PORTABLE ONE LLC
Entity Type:Organization
Organization Name:PORTABLE ONE LLC
Other - Org Name:PORTABLE ACCESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:833-491-9191
Mailing Address - Street 1:4091 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SHADYSIDE
Mailing Address - State:OH
Mailing Address - Zip Code:43947-1234
Mailing Address - Country:US
Mailing Address - Phone:855-491-9191
Mailing Address - Fax:855-291-9343
Practice Address - Street 1:4091 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SHADYSIDE
Practice Address - State:OH
Practice Address - Zip Code:43947-1234
Practice Address - Country:US
Practice Address - Phone:855-491-9191
Practice Address - Fax:855-291-9343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)