Provider Demographics
NPI:1629387246
Name:1ST ADVANCED TRANSPORTATION
Entity type:Organization
Organization Name:1ST ADVANCED TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-B
Authorized Official - Phone:614-348-9991
Mailing Address - Street 1:555 OFFICENTER PL
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-5333
Mailing Address - Country:US
Mailing Address - Phone:614-348-9991
Mailing Address - Fax:614-418-7085
Practice Address - Street 1:555 OFFICENTER PL
Practice Address - Street 2:SUITE 103
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-5333
Practice Address - Country:US
Practice Address - Phone:614-348-9991
Practice Address - Fax:614-418-7085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH255135343900000X
OH2500123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9354721Medicare PIN