Organization
LAKETRAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDY ALTENWEG (DEPUTY GENERAL MANAGER)
(440) 350-1017
Entity
Organization
Contact information
Practice address
555 LAKESHORE BLVD, PAINESVILLE, OH 44077-1121
(440) 350-1000
Mailing address
555 LAKESHORE BLVD, PAINESVILLE, OH 44077-1121
(440) 350-1000
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2804906
—
OH
Enumeration date
09/25/2008
Last updated
09/26/2008
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