MEDICARE: FROM MY DOOR 2 YOUR DOOR 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)

General Provider Information

NPI Number	:	1356061709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FROM MY DOOR 2 YOUR DOOR LLC

Provider Business Mailing Address
First Line	:	6605 KIRKLAND DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-1244
Country	:	US
Telephone Number	:	513-828-8689
Fax Number	:

Provider Business Practice Location Address
First Line	:	6605 KIRKLAND DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-1244
Country	:	US
Telephone Number	:	513-828-8689
Fax Number	:

Authorized Official
Title or Position	:	OWNER, CEO
Name	:	MR. RAHMAN A SHABAZZ
Credential	:
Telephone Number	:	513-828-8689

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	08/29/2022

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Directions to “FROM MY DOOR 2 YOUR DOOR LLC ” Practice Location

Language	Start Address	Practice Location

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