MEDICARE: LYONS TRANSPORT INC.

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	:	1649441957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYONS TRANSPORT INC.

Provider Business Mailing Address
First Line	:	29532 SOUTHFIELD RD
Second Line	:	101
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-2023
Country	:	US
Telephone Number	:	248-559-5591
Fax Number	:

Provider Business Practice Location Address
First Line	:	29532 SOUTHFIELD RD
Second Line	:	101
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-2023
Country	:	US
Telephone Number	:	248-559-5591
Fax Number	:	248-559-5771

Authorized Official
Title or Position	:	SENIOR OFFICE MGR
Name	:	VANITA GREENE
Credential	:	NA
Telephone Number	:	877-566-3383

Provider Enumeration Date	:	03/13/2008
Last Update Date	:	03/13/2008

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