MEDICARE: HORIZON MEDICAL TRANSPORTATION

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)	WMATC # 1145	DC

General Provider Information

NPI Number	:	1407033541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZON MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	6428 LANDING WAY
Second Line	:
City	:	NEW CARROLLTON
State	:	MD
Zip	:	20784-4619
Country	:	US
Telephone Number	:	301-442-1801
Fax Number	:	301-306-0726

Provider Business Practice Location Address
First Line	:	6428 LANDING WAY
Second Line	:
City	:	NEW CARROLLTON
State	:	MD
Zip	:	20784-4619
Country	:	US
Telephone Number	:	301-442-1801
Fax Number	:	301-306-0726

Authorized Official
Title or Position	:	CEO
Name	:	MR. DIVINE BERINYUY JIMLA
Credential	:
Telephone Number	:	301-442-1801

Provider Enumeration Date	:	01/30/2008
Last Update Date	:	01/30/2008

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Directions to “HORIZON MEDICAL TRANSPORTATION ” Practice Location

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