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? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OH | 00000000 | Medicaid |