Provider Demographics
NPI:1245089648
Name:C-1ST LLC
Entity type:Organization
Organization Name:C-1ST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRESHAM
Authorized Official - Suffix:JR
Authorized Official - Credentials:OWNER
Authorized Official - Phone:813-766-1643
Mailing Address - Street 1:828 LANE ST
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-3848
Mailing Address - Country:US
Mailing Address - Phone:813-766-1643
Mailing Address - Fax:
Practice Address - Street 1:828 LANE ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3848
Practice Address - Country:US
Practice Address - Phone:813-766-1643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)