Provider Demographics
NPI:1588343636
Name:VAZQUEST CARES TRANSPORT
Entity type:Organization
Organization Name:VAZQUEST CARES TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER/DRIVER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:MELVIN
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:216-315-0781
Mailing Address - Street 1:15728 LORAIN AVE # 8073
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5542
Mailing Address - Country:US
Mailing Address - Phone:216-315-0781
Mailing Address - Fax:
Practice Address - Street 1:11100 FORTUNE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3724
Practice Address - Country:US
Practice Address - Phone:216-315-0781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)