=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245042852
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACE TAXI SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2025
-----------------------------------------------------
Last Update Date | 01/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 134 E CENTER ST
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06040-5252
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-222-2222
-----------------------------------------------------
Fax | 860-926-4116
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 411
-----------------------------------------------------
City | VERNON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06066-0411
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-222-2222
-----------------------------------------------------
Fax | 860-926-4116
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY
-----------------------------------------------------
Name | SHANNON WILSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 860-222-2222
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------