Organization
SPEEDWAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEKSANDR KATSMAN AMBULETTE (OWNER)
(216) 355-8011
Entity
Organization
Contact information
Practice address
27645 BISHOP PARK DR #508, WICKLIFFE, OH 44092-2763
(216) 355-8011
(440) 347-9939
Mailing address
27645 BISHOP PARK DR #508, WICKLIFFE, OH 44092-2763
(216) 355-8011
(440) 347-9939
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
435075
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2659234
—
OH
Enumeration date
01/17/2007
Last updated
08/22/2020
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