Provider Demographics
NPI:1700523529
Name:STANSTEPH TRANSPORTATION LLC
Entity Type:Organization
Organization Name:STANSTEPH TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADU-GYAMFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-937-7744
Mailing Address - Street 1:4370 COBLE GLEN LN
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-7755
Mailing Address - Country:US
Mailing Address - Phone:614-256-0744
Mailing Address - Fax:
Practice Address - Street 1:4370 COBLE GLEN LN
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-7755
Practice Address - Country:US
Practice Address - Phone:614-256-0744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH00000000Medicaid