Provider Demographics
NPI:1720398779
Name:BJS HAVEN TRANSPORTATION SPECIALISTS LLC
Entity Type:Organization
Organization Name:BJS HAVEN TRANSPORTATION SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEGAL AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:MCALLISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-206-1868
Mailing Address - Street 1:7426 WORLEY AVE
Mailing Address - Street 2:7426 WORLEY AVENUE
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-3835
Mailing Address - Country:US
Mailing Address - Phone:216-429-2454
Mailing Address - Fax:
Practice Address - Street 1:7426 WORLEY AVE
Practice Address - Street 2:7426 WORLEY AVENUE
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-3835
Practice Address - Country:US
Practice Address - Phone:216-429-2454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH188215343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)