Provider Demographics
NPI:1336560077
Name:AAA OHIO TRANSPORTATION,LLC
Entity type:Organization
Organization Name:AAA OHIO TRANSPORTATION,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAID
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:YUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-530-2649
Mailing Address - Street 1:3320 SYCAMORE KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3063
Mailing Address - Country:US
Mailing Address - Phone:614-602-7035
Mailing Address - Fax:
Practice Address - Street 1:3320 SYCAMORE KNOLLS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3063
Practice Address - Country:US
Practice Address - Phone:614-602-7035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-24
Last Update Date:2014-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH259795343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0091183Medicaid