MEDICARE: HEAVY TRANSPORTATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	347B00000X	Bus
2	347C00000X	Private Vehicle
3	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1962201962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAVY TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	2927 HEARTHSIDE DR
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-6791
Country	:	US
Telephone Number	:	131-777-7810
Fax Number	:

Provider Business Practice Location Address
First Line	:	2927 HEARTHSIDE DR
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-6791
Country	:	US
Telephone Number	:	317-777-8106
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SHANITRA LACHE KING
Credential	:
Telephone Number	:	317-777-8106

Provider Enumeration Date	:	03/11/2025
Last Update Date	:	03/11/2025

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Directions to “HEAVY TRANSPORTATION LLC ” Practice Location

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