MEDICARE: MR. JOHN FORD JR.

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)	SJ481238	OH

General Provider Information

NPI Number	:	1427434919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN FORD JR.

Provider Business Mailing Address
First Line	:	1448 E 112TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1322
Country	:	US
Telephone Number	:	216-712-2502
Fax Number	:

Provider Business Practice Location Address
First Line	:	1448 E 112TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1322
Country	:	US
Telephone Number	:	216-712-2502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2015
Last Update Date	:	08/06/2015

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Directions to “ MR. JOHN FORD JR. ” Practice Location

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