Provider Demographics
NPI:1457524340
Name:MEDPORT INC
Entity Type:Organization
Organization Name:MEDPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:REINHOLZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:216-587-9715
Mailing Address - Street 1:9400 MIDWEST AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2420
Mailing Address - Country:US
Mailing Address - Phone:216-587-9715
Mailing Address - Fax:216-662-0052
Practice Address - Street 1:9400 MIDWEST AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2420
Practice Address - Country:US
Practice Address - Phone:216-587-9715
Practice Address - Fax:216-662-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
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
OH2788470OtherPASSPORT