Provider Demographics
NPI:1750997136
Name:SOUTH EAST AREA TRANSIT
Entity type:Organization
Organization Name:SOUTH EAST AREA TRANSIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-454-8574
Mailing Address - Street 1:375 FAIRBANKS ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-3043
Mailing Address - Country:US
Mailing Address - Phone:740-454-8574
Mailing Address - Fax:888-656-1038
Practice Address - Street 1:375 FAIRBANKS ST
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-3043
Practice Address - Country:US
Practice Address - Phone:740-454-8574
Practice Address - Fax:888-656-1038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347B00000XTransportation ServicesBus
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0251552Medicaid