Healthcare Provider Details

I. General information

NPI: 1326735689
Provider Name (Legal Business Name): ANDERSON MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 ENGLAND ST
PICKERINGTON OH
43147-2248
US

IV. Provider business mailing address

237 ENGLAND ST
PICKERINGTON OH
43147-2248
US

V. Phone/Fax

Practice location:
  • Phone: 614-266-3602
  • Fax:
Mailing address:
  • Phone: 614-266-3602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH C ANDERSON
Title or Position: OWNER
Credential: BSN, RN
Phone: 614-266-3602