Provider Demographics
NPI:1952873366
Name:MANAGED TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:MANAGED TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WISSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-300-1900
Mailing Address - Street 1:7849 PALACE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-1635
Mailing Address - Country:US
Mailing Address - Phone:513-898-2125
Mailing Address - Fax:
Practice Address - Street 1:7849 PALACE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-1635
Practice Address - Country:US
Practice Address - Phone:513-898-2125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-23
Last Update Date:2018-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)