MEDICARE: PATTERSON NON EMERGENCY MEDICAL TRAQNSPORT

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)

General Provider Information

NPI Number	:	1295474112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATTERSON NON EMERGENCY MEDICAL TRAQNSPORT

Provider Business Mailing Address
First Line	:	5915 BONNIE DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-7502
Country	:	US
Telephone Number	:	405-532-3223
Fax Number	:

Provider Business Practice Location Address
First Line	:	5915 BONNIE DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-7502
Country	:	US
Telephone Number	:	405-532-3223
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. LEWIS PATTERSON
Credential	:
Telephone Number	:	405-532-3223

Provider Enumeration Date	:	05/31/2022
Last Update Date	:	05/31/2022

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