Provider Demographics
NPI:1427525336
Name:ISAAC TRANSPORTATION
Entity type:Organization
Organization Name:ISAAC TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KHAIRYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISHAG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:330-351-7008
Mailing Address - Street 1:90 CRYSTAL LAKE RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-1786
Mailing Address - Country:US
Mailing Address - Phone:330-351-7008
Mailing Address - Fax:
Practice Address - Street 1:90 CRYSTAL LAKE RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-1786
Practice Address - Country:US
Practice Address - Phone:330-351-7008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3075569Medicaid