Provider Demographics
NPI:1447976485
Name:PENN 3 LOGISTICS LLC
Entity type:Organization
Organization Name:PENN 3 LOGISTICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:
Authorized Official - Last Name:PENN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:216-337-7045
Mailing Address - Street 1:15728 LORAIN AVE UNIT 40
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5542
Mailing Address - Country:US
Mailing Address - Phone:440-558-6588
Mailing Address - Fax:
Practice Address - Street 1:6020 S PARK BLVD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-3659
Practice Address - Country:US
Practice Address - Phone:440-558-6588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)