Provider Demographics
NPI:1740906429
Name:RAW TRANSPORTATION LLC
Entity type:Organization
Organization Name:RAW TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:216-414-5947
Mailing Address - Street 1:PO BOX 201111
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-8101
Mailing Address - Country:US
Mailing Address - Phone:216-414-5947
Mailing Address - Fax:
Practice Address - Street 1:4080 E 155TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1917
Practice Address - Country:US
Practice Address - Phone:216-414-5947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)