Provider Demographics
NPI:1528253812
Name:SPEEDY MEDICAL TRANSPORTATION INC
Entity type:Organization
Organization Name:SPEEDY MEDICAL TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IHAB
Authorized Official - Middle Name:R
Authorized Official - Last Name:TRAISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-310-6142
Mailing Address - Street 1:300 E EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1760
Mailing Address - Country:US
Mailing Address - Phone:330-315-3667
Mailing Address - Fax:330-535-0339
Practice Address - Street 1:300 E EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1760
Practice Address - Country:US
Practice Address - Phone:330-315-3667
Practice Address - Fax:330-535-0339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2500805343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2500805Medicaid