Provider Demographics
NPI:1730819889
Name:CLEVELAND TRANSPORT LLC
Entity type:Organization
Organization Name:CLEVELAND TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BURCHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-545-4883
Mailing Address - Street 1:PO BOX 476
Mailing Address - Street 2:
Mailing Address - City:BOYLE
Mailing Address - State:MS
Mailing Address - Zip Code:38730-0476
Mailing Address - Country:US
Mailing Address - Phone:662-907-4041
Mailing Address - Fax:
Practice Address - Street 1:552 N BAYOU RD
Practice Address - Street 2:
Practice Address - City:BOYLE
Practice Address - State:MS
Practice Address - Zip Code:38730-9665
Practice Address - Country:US
Practice Address - Phone:662-545-4883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)