MEDICARE: GO GREEN TRANSPORTATION INC.

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)		CA

General Provider Information

NPI Number	:	1285970426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GO GREEN TRANSPORTATION INC.

Provider Business Mailing Address
First Line	:	20630 JOHN DR
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-5123
Country	:	US
Telephone Number	:	510-464-7336
Fax Number	:	510-889-7524

Provider Business Practice Location Address
First Line	:	20630 JOHN DR
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-5123
Country	:	US
Telephone Number	:	510-464-7336
Fax Number	:	510-889-7524

Authorized Official
Title or Position	:	CEO
Name	:	MRS. RITA ANN HOOPES
Credential	:
Telephone Number	:	510-464-7336

Provider Enumeration Date	:	12/17/2012
Last Update Date	:	12/17/2012

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