Provider Demographics
NPI:1245501196
Name:A&E TRANSPORTATION SERVICE
Entity type:Organization
Organization Name:A&E TRANSPORTATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:T
Authorized Official - Last Name:KENNEDY-COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-253-6227
Mailing Address - Street 1:4125 PRINCETON BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2342
Mailing Address - Country:US
Mailing Address - Phone:216-253-6227
Mailing Address - Fax:216-381-1200
Practice Address - Street 1:4125 PRINCETON BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-2342
Practice Address - Country:US
Practice Address - Phone:216-253-6227
Practice Address - Fax:216-381-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3057098Medicaid