Provider Demographics
NPI:1285775890
Name:PEACE TRANSPORTATION CORP. DBA PEACE HOME CARE SERVICES
Entity type:Organization
Organization Name:PEACE TRANSPORTATION CORP. DBA PEACE HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-880-1099
Mailing Address - Street 1:2804 JOHNSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-2322
Mailing Address - Country:US
Mailing Address - Phone:614-880-1099
Mailing Address - Fax:614-559-3923
Practice Address - Street 1:2804 JOHNSTOWN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219
Practice Address - Country:US
Practice Address - Phone:614-880-1099
Practice Address - Fax:614-559-3923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSW710668343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH270-0401Medicaid
OH2727802Medicaid