MEDICARE: P.S.C. TRANSPORTATION INCORPORATED

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	343800000X	Secured Medical Transport (VAN)	187175	OH
2	343800000X	Secured Medical Transport (VAN)	180695	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063604122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	P.S.C. TRANSPORTATION INCORPORATED

Provider Business Mailing Address
First Line	:	4421 RENAISSANCE PKWY
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44128-5754
Country	:	US
Telephone Number	:	440-804-4382
Fax Number	:	216-378-2913

Provider Business Practice Location Address
First Line	:	4421 RENAISSANCE PKWY
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44128-5754
Country	:	US
Telephone Number	:	440-804-4382
Fax Number	:	216-378-2913

Authorized Official
Title or Position	:	CHIEF OWNER OPERATOR
Name	:	MR. EDWARD O OZUEM SR.
Credential	:
Telephone Number	:	216-378-2911

Provider Enumeration Date	:	08/13/2007
Last Update Date	:	06/16/2018

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Directions to “P.S.C. TRANSPORTATION INCORPORATED ” Practice Location

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