Provider Demographics
NPI:1245323567
Name:TEAM TRANSPORTATION RESOURCES, INC.
Entity type:Organization
Organization Name:TEAM TRANSPORTATION RESOURCES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:MOHAMUD
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:SR
Authorized Official - Credentials:NONEMERGENCY TRANSPO
Authorized Official - Phone:614-418-0073
Mailing Address - Street 1:3310 MORSE RD STE 105/108
Mailing Address - Street 2:N/A
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6191
Mailing Address - Country:US
Mailing Address - Phone:614-418-0073
Mailing Address - Fax:614-418-0074
Practice Address - Street 1:3310 MORSE RD STE 105/108
Practice Address - Street 2:N/A
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6191
Practice Address - Country:US
Practice Address - Phone:614-418-0073
Practice Address - Fax:614-418-0074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH255495343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2633654Medicaid