Edgewater Golf Inc
Organization Active NPI Transportation Broker · Minerva, OH
NPI 1649884123 · NPPES record last updated Sep 2, 2020
Key facts
- NPI
- 1649884123
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Transportation Broker 347E00000X
- Legal business name
- EDGEWATER GOLF INC
- Practice address
- 2401 Fox Ave SE
Minerva, OH 44657-9146 - Phone
- (330) 771-4830
- Fax
- (330) 862-2510
- NPI assigned
- Sep 2, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- EDGEWATER GOLF INC.
Authorized official
- Name
- Ms. Diane M Simms
- Title
- President
- Phone
- (330) 771-4830
Practitioners 1
National Provider Directory
- Part of
- Edgewater Golf Inc
Locations
2401 Fox Ave SE
Minerva, OH 44657
Phone (330) 771-4830
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Transportation Broker | 347E00000X | Yes |
Addresses
Primary practice location
2401 Fox Ave SE
Minerva, OH 44657-9146
Mailing address
2401 Fox Ave SE
Minerva, OH 44657-9146
Phone (330) 771-4830
Other names
- Green Wolf Transportation
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- Edward N. Barr
- Andrea Lynn Evans
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All providers in Minerva, OH · Transportation Broker in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.