Provider Demographics
NPI:1356930168
Name:THE PORTER FOUNDATION OF OHIO
Entity type:Organization
Organization Name:THE PORTER FOUNDATION OF OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHIMEREA
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-456-1530
Mailing Address - Street 1:16212 KOLLIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-3808
Mailing Address - Country:US
Mailing Address - Phone:216-456-1530
Mailing Address - Fax:
Practice Address - Street 1:1013 ROCKSIDE RD STE C
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-2700
Practice Address - Country:US
Practice Address - Phone:216-456-1530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)