Provider Demographics
NPI:1265793962
Name:STEVENSON TRANSPORTATION, LLC
Entity type:Organization
Organization Name:STEVENSON TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:440-232-8750
Mailing Address - Street 1:6033 RANDY RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-3034
Mailing Address - Country:US
Mailing Address - Phone:440-232-8750
Mailing Address - Fax:
Practice Address - Street 1:6033 RANDY RD
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-3034
Practice Address - Country:US
Practice Address - Phone:440-232-8750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH188935343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0054164Medicaid