MEDICARE: SPOTLIGHT 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)

General Provider Information

NPI Number	:	1841897378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPOTLIGHT TRANSPORTATION

Provider Business Mailing Address
First Line	:	2804 55TH PL STE E
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-3546
Country	:	US
Telephone Number	:	317-523-8189
Fax Number	:	317-981-1702

Provider Business Practice Location Address
First Line	:	2804 55TH PL STE E
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-3546
Country	:	US
Telephone Number	:	317-523-8189
Fax Number	:	317-981-1702

Authorized Official
Title or Position	:	OWNER
Name	:	LAKIA BARTLETT
Credential	:
Telephone Number	:	317-702-5187

Provider Enumeration Date	:	10/07/2020
Last Update Date	:	10/07/2020

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