Provider Demographics
NPI:1447465745
Name:C G G INC DBA C G G AMBULETTE
Entity type:Organization
Organization Name:C G G INC DBA C G G AMBULETTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-851-5300
Mailing Address - Street 1:8060 READING RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-1414
Mailing Address - Country:US
Mailing Address - Phone:513-851-5300
Mailing Address - Fax:513-851-3456
Practice Address - Street 1:8060 READING RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-1414
Practice Address - Country:US
Practice Address - Phone:513-851-5300
Practice Address - Fax:513-851-3456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2308363Medicaid