MEDICARE: LOVEISTRANSPORTATION

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	:	1417793803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVEISTRANSPORTATION

Provider Business Mailing Address
First Line	:	3529 W 38TH ST UNIT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60632-3342
Country	:	US
Telephone Number	:	312-731-4036
Fax Number	:

Provider Business Practice Location Address
First Line	:	3529 W 38TH ST UNIT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60632-3342
Country	:	US
Telephone Number	:	312-731-4036
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROBIN MOSS
Credential	:
Telephone Number	:	312-731-4036

Provider Enumeration Date	:	07/04/2024
Last Update Date	:	07/04/2024

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