Provider Demographics
NPI:1649676537
Name:JEFFREY DEAN FOUNDATION
Entity type:Organization
Organization Name:JEFFREY DEAN FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:PEAKS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:614-398-1311
Mailing Address - Street 1:2572 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-1679
Mailing Address - Country:US
Mailing Address - Phone:614-398-1311
Mailing Address - Fax:614-398-1311
Practice Address - Street 1:2572 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-1679
Practice Address - Country:US
Practice Address - Phone:614-398-1311
Practice Address - Fax:614-398-1311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH250565343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)