MEDICARE: BUZY AS A BEAVER TRANSPORTATION, 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	:	1952629784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUZY AS A BEAVER TRANSPORTATION, INC

Provider Business Mailing Address
First Line	:	6730 S LANGLEY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-4137
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6730 S LANGLEY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-4137
Country	:	US
Telephone Number	:	773-324-1422
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. NICHOLE J DRIVER
Credential	:
Telephone Number	:	773-230-3155

Provider Enumeration Date	:	05/04/2010
Last Update Date	:	05/04/2010

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