Provider Demographics
NPI:1770207425
Name:ST AUGUSTINE TRANSPORTATION
Entity type:Organization
Organization Name:ST AUGUSTINE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-634-7555
Mailing Address - Street 1:7801 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102
Mailing Address - Country:US
Mailing Address - Phone:216-634-7400
Mailing Address - Fax:216-634-7438
Practice Address - Street 1:7801 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102
Practice Address - Country:US
Practice Address - Phone:216-634-7400
Practice Address - Fax:216-634-7438
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST AUGUSTINE MANOR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)