Provider Demographics
NPI:1750429221
Name:GOOD SHEPHERD AMBULANCE LLC
Entity type:Organization
Organization Name:GOOD SHEPHERD AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-240-9474
Mailing Address - Street 1:3570 W 140TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-2410
Mailing Address - Country:US
Mailing Address - Phone:216-476-9200
Mailing Address - Fax:216-476-9202
Practice Address - Street 1:3570 W 140TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-2410
Practice Address - Country:US
Practice Address - Phone:216-476-9200
Practice Address - Fax:216-476-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport