MEDICARE: SIRRAH TRANSPORTATION SVCS, 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)		OH

General Provider Information

NPI Number	:	1104101955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIRRAH TRANSPORTATION SVCS, LLC

Provider Business Mailing Address
First Line	:	2490 LEE BLVD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44118-1268
Country	:	US
Telephone Number	:	216-862-3742
Fax Number	:

Provider Business Practice Location Address
First Line	:	2490 LEE BLVD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44118-1268
Country	:	US
Telephone Number	:	216-862-3742
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. P DENIECE HARRIS
Credential	:
Telephone Number	:	216-862-3742

Provider Enumeration Date	:	10/12/2011
Last Update Date	:	10/12/2011

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