Speedway

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

435075 Issued in OH

Legal business name

SPEEDWAY

Practice address

27645 Bishop Park Dr #508
Wickliffe, OH 44092-2763

Phone

(216) 355-8011

Fax

(440) 347-9939

NPI assigned

Jan 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aleksandr Katsman, AMBULETTE

Title

Owner

Phone

(216) 355-8011

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114079688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27645 BISHOP PARK DR #508",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440922763",
            "telephone_number": "216-355-8011",
            "fax_number": "440-347-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27645 BISHOP PARK DR #508",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440922763",
            "telephone_number": "216-355-8011",
            "fax_number": "440-347-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEEDWAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KATSMAN",
        "authorized_official_first_name": "ALEKSANDR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-355-8011",
        "authorized_official_credential": "AMBULETTE"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "OH",
            "license": "435075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2659234",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Qiania Smiley
• Glynnisha Smith
• Virginia Eileen Strenger, PHD
• Supportive Care of Ohio LLC
• Brittanie Nikol Svoboda, NP-C
• Susan Joan Sweigert
• Tapestry Wickliffe Senior Housing Management, LLC

• Non-emergency Medical Transport (VAN) in Wickliffe, OH
• Providers in Wickliffe, OH by specialty
• Non-emergency Medical Transport (VAN) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.