Organization
EXTRACARE LLC
Active
Other names
EXTRACARE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
EUEL KASAYE (OWNER)
(614) 806-4465
Entity
Organization
Contact information
Practice address
5969 E LIVINGSTON AVE STE 209, COLUMBUS, OH 43232-2907
(614) 806-4465
Mailing address
5969 E LIVINGSTON AVE STE 209, COLUMBUS, OH 43232-2907
(614) 806-4465
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108317
—
OH
Enumeration date
04/10/2018
Last updated
06/19/2019
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