Provider Demographics
NPI:1295077915
Name:SPEEDY WHEELS TRANSPORTATION
Entity type:Organization
Organization Name:SPEEDY WHEELS TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:LATONDA
Authorized Official - Middle Name:CHAMAR
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-965-4202
Mailing Address - Street 1:3857 E 155TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-1256
Mailing Address - Country:US
Mailing Address - Phone:216-965-4202
Mailing Address - Fax:
Practice Address - Street 1:3857 E 155TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1256
Practice Address - Country:US
Practice Address - Phone:216-965-4202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle