Provider Demographics
NPI:1336560689
Name:PARKMANOR MEDICAL TRANSPORT
Entity Type:Organization
Organization Name:PARKMANOR MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-207-1098
Mailing Address - Street 1:11760 PELLSTON CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-4122
Mailing Address - Country:US
Mailing Address - Phone:513-851-8400
Mailing Address - Fax:513-674-3210
Practice Address - Street 1:11760 PELLSTON CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-4122
Practice Address - Country:US
Practice Address - Phone:513-851-8400
Practice Address - Fax:513-674-3210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)