Organization
LAKEFRONT TRANSPORTATION INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLON LERON OWENS (CEO)
(216) 702-4415
Entity
Organization
Contact information
Practice address
5 SEVERANCE CIR STE 502, CLEVELAND HEIGHTS, OH 44118-1588
(216) 702-4415
(216) 472-8521
Mailing address
5 SEVERANCE CIR STE 502, CLEVELAND HEIGHTS, OH 44118-1588
(216) 702-4415
(216) 472-8521
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0271829
—
OH
Enumeration date
05/15/2019
Last updated
07/10/2019
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