Organization
OHIO MED LIFE TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. R LEAH BURKE (OWNER OPERATOR)
(740) 600-2256
Entity
Organization
Contact information
Practice address
29200 CREIGHTON RD, CLARKSBURG, OH 43115-9623
(740) 600-2256
Mailing address
29200 CREIGHTON RD, CLARKSBURG, OH 43115-9623
(740) 600-2256
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
715075
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
715075
LICENSE NUMBER
OH
Enumeration date
03/22/2016
Last updated
03/22/2016
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