MEDICARE: OZLAND CONSULTING, 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)	2150024021	IN
2	347C00000X	Private Vehicle	2150024021	IN

General Provider Information

NPI Number	:	1093152472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OZLAND CONSULTING, LLC

Provider Business Mailing Address
First Line	:	2801 W 29TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-2226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 W 29TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-2226
Country	:	US
Telephone Number	:	866-850-6671
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CARMEN GRAVES-OSBORN
Credential	:
Telephone Number	:	866-850-6671

Provider Enumeration Date	:	05/26/2013
Last Update Date	:	07/09/2013

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Directions to “OZLAND CONSULTING, LLC ” Practice Location

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