MEDICARE: FRED A CONTANT

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)	GSK7635	OH
2	172A00000X	Driver	GSK7635	OH

General Provider Information

NPI Number	:	1114890522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRED A CONTANT

Provider Business Mailing Address
First Line	:	8004 PARADISE CV
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-8947
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8004 PARADISE CV
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-8947
Country	:	US
Telephone Number	:	513-849-6865
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	09/24/2025

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Directions to “ FRED A CONTANT ” Practice Location

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