Provider Demographics
NPI:1841079126
Name:WELLWAY MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:WELLWAY MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARSCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:PACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-394-6799
Mailing Address - Street 1:311 ELM ST STE 270
Mailing Address - Street 2:#1303
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202
Mailing Address - Country:US
Mailing Address - Phone:513-394-6799
Mailing Address - Fax:
Practice Address - Street 1:311 ELM ST STE 270
Practice Address - Street 2:#1303
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202
Practice Address - Country:US
Practice Address - Phone:513-394-6799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)