EDGEWATER GOLF INC (NPI# 1649884123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649884123 |
| Entity Type | Organization |
| Organization Name | EDGEWATER GOLF INC |
| Practice Address |
2401 Fox Ave Se Minerva OH 44657-9146 |
| Practice Telephone | 3307714830 |
| Practice Fax Number | 3308622510 |
| Mailing Telephone | 3307714830 |
| Mailing Fax Number | 3308622510 |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |
| Authorized Official Name | MS. DIANE M SIMMS (PRESIDENT) |
| Authorized Official Telephone | 3307714830 |
| Is Organization Subpart | Y |
| Parent Organization Name | EDGEWATER GOLF INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 347E00000X | Transportation Broker | Transportation Services |
| Other Name | Type Code |
|---|---|
| Green Wolf Transportation | Doing Business As Name - Organization |
| Street Address |
2401 FOX AVE SE |
| City | MINERVA |
| State | OH |
| Zip Code | 44657-9146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162541 | Diane Marie Simms | Transportation Broker | 2401 Fox Ave Se, Minerva, OH 44657-9146 | 2020-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235670563 | Melody Lynn Katich | Home Health Aide | 16600 Georgetown Street, Minerva, OH 44657 | 2017-03-20 |
| 1275926743 | Ellen Doney | Technician | 1200 Valley St., Apt B84, Minerva, OH 44657 | 2015-03-09 |
| 1720312119 | Lolly Ann Brown | Licensed Practical Nurse | 305 High St, Minerva, OH 44657 | 2009-10-01 |
| 1922332394 | Bobbi Jo Lovejoy | Registered Nurse | 22847 Ellsworth Ave., Minerva, OH 44657 | 2009-10-01 |
| 1962624130 | Robert Kenneth Nichols | Chiropractor | 15245 Lincolnway Se, Minerva, OH 44657 | 2007-05-03 |
| 1871647230 | Ted A Rath | Optometrist | 1174 Alliance Road, Minerva, OH 44657 | 2007-01-23 |
| 1801901681 | Marjorie Ann Versiackas | Licensed Practical Nurse | 3695 Fox Ave Ne, Minerva, OH 44657 | 2006-08-20 |
| 1578511077 | Minerva Convalescent Center LLC | Skilled Nursing Facility | 1035 East Lincolnway, Minerva, OH 44657 | 2006-05-05 |
| 1629399639 | Cheryl A. Gilson | Licensed Practical Nurse | 16464 Delmar Dr Se, Minerva, OH 44657-1006 | 2010-06-14 |
| 1932120979 | Premier Health Associates Inc | Internal Medicine | 625 N Market St, Minerva, OH 44657-1027 | 2006-07-23 |
| Find all providers in zip 44657 | ||||
| Taxonomy Code | 347E00000X |
| Grouping | Transportation Services |
| Classification | Transportation Broker |
| A public or private organization or business contracted to arrange non-emergency medical transportation services, including appropriate ancillary services, e.g., lodging. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162541 | Diane Marie Simms | Transportation Broker | 2401 Fox Ave Se, Minerva, OH 44657-9146 | 2020-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184231862 | Kim M Ortman | Transportation Broker | 5745 Curnie Dr, Hamilton, OH 45013-9068 | 2020-09-28 |
| 1134734759 | Amistad Heritage LLC | Transportation Broker | 17325 Euclid Ave Ste 2007, Cleveland, OH 44112-1250 | 2020-09-10 |
| 1750991329 | Anthony J Hills | Transportation Broker | 1368 Plainfield Rd, South Euclid, OH 44121-2512 | 2020-08-07 |
| 1609404524 | Michael's Angels Transportation Services LLC | Transportation Broker | 2020 Brice Rd Ste 240, Reynoldsburg, OH 43068-3428 | 2020-03-27 |
| 1548895188 | Majors Transportation LLC | Transportation Broker | 6315 Upperridge Dr, Canal Winchester, OH 43110-9769 | 2020-03-04 |
| 1497388631 | Zoe Wheels | Transportation Broker | 31 E Firestone Blvd Apt 8a, Akron, OH 44301-1642 | 2020-02-17 |
| 1023648367 | Night Moonlight Transportation Inc | Transportation Broker | 5141 Meadowfield Ln, Hilliard, OH 43026-7678 | 2020-01-24 |
| 1144850884 | Connect Transportation Services LLC | Transportation Broker | 1338 Delano Rd, Chillicothe, OH 45601-8440 | 2020-01-22 |
| 1790346203 | Travonna Nicole Perry | Transportation Broker | 3840 Jackman Rd, Toledo, OH 43612-1119 | 2019-06-25 |
| 1346809399 | Marsha Dunn | Transportation Broker | 6404 Wall St, Ravenna, OH 44266-1774 | 2019-06-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.