Provider Demographics
NPI:1669074480
Name:BUTLER COUNTY REGIONAL TRANSIT AUTHORITY
Entity type:Organization
Organization Name:BUTLER COUNTY REGIONAL TRANSIT AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:DUTKEVICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-785-5246
Mailing Address - Street 1:3045 MOSER CT
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-5373
Mailing Address - Country:US
Mailing Address - Phone:513-785-5237
Mailing Address - Fax:
Practice Address - Street 1:3045 MOSER CT
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-5373
Practice Address - Country:US
Practice Address - Phone:513-785-5237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0905702Medicaid