Provider Demographics
NPI:1255143350
Name:MICHAELS PREMIUM TRANSPORTATION SERVICES
Entity type:Organization
Organization Name:MICHAELS PREMIUM TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FOUAD
Authorized Official - Middle Name:ISSA
Authorized Official - Last Name:MICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-212-9567
Mailing Address - Street 1:3915 BUECHNER AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-5028
Mailing Address - Country:US
Mailing Address - Phone:440-212-9567
Mailing Address - Fax:
Practice Address - Street 1:3915 BUECHNER AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-5028
Practice Address - Country:US
Practice Address - Phone:440-212-9567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)