Provider Demographics
NPI:1306147897
Name:HARRISON TRANSPORTATION MANAGEMENT, LLC
Entity type:Organization
Organization Name:HARRISON TRANSPORTATION MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANIKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:614-755-3990
Mailing Address - Street 1:1249 CEDON RUN DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-9189
Mailing Address - Country:US
Mailing Address - Phone:614-755-3990
Mailing Address - Fax:614-755-3994
Practice Address - Street 1:1249 CEDON RUN DR
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-9189
Practice Address - Country:US
Practice Address - Phone:614-755-3990
Practice Address - Fax:614-755-3994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2961648Medicaid