Provider Demographics
NPI:1750515425
Name:ALLEN COUNTY REGIONAL TRANSIT AUTHORITY
Entity type:Organization
Organization Name:ALLEN COUNTY REGIONAL TRANSIT AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:KITCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-222-2872
Mailing Address - Street 1:200 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4424
Mailing Address - Country:US
Mailing Address - Phone:419-222-2872
Mailing Address - Fax:419-224-0989
Practice Address - Street 1:200 E HIGH ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4424
Practice Address - Country:US
Practice Address - Phone:419-222-2872
Practice Address - Fax:419-224-0989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0200740Medicaid