MEDICARE: ZERUBBABLE TRANSPORTATION 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	:	1679334247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZERUBBABLE TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	5060 DELLERS GLEN DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-4869
Country	:	US
Telephone Number	:	510-586-5799
Fax Number	:

Provider Business Practice Location Address
First Line	:	5060 DELLERS GLEN DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-4869
Country	:	US
Telephone Number	:	510-586-5799
Fax Number	:

Authorized Official
Title or Position	:	DRIVER
Name	:	ABDISSA F BIRRU
Credential	:	N/A
Telephone Number	:	510-586-5799

Provider Enumeration Date	:	01/19/2024
Last Update Date	:	01/22/2024

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