MEDICARE: H&H TAXI, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)		KY

General Provider Information

NPI Number	:	1053753673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H&H TAXI, LLC

Provider Business Mailing Address
First Line	:	PO BOX 16
Second Line	:
City	:	RUSSELL SPRINGS
State	:	KY
Zip	:	42642-4357
Country	:	US
Telephone Number	:	270-866-3456
Fax Number	:

Provider Business Practice Location Address
First Line	:	539 MAIN ST
Second Line	:
City	:	RUSSELL SPRINGS
State	:	KY
Zip	:	42642-4357
Country	:	US
Telephone Number	:	270-866-3456
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. JASON GRIDER
Credential	:
Telephone Number	:	270-866-3456

Provider Enumeration Date	:	07/24/2013
Last Update Date	:	07/24/2013

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