MEDICARE: MEDICAL TRANSPORTATION SERVICE L.L.P.

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	:	1003226754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL TRANSPORTATION SERVICE L.L.P.

Provider Business Mailing Address
First Line	:	104 HIGH CIR
Second Line	:	APARTMENT 8B
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-2338
Country	:	US
Telephone Number	:	843-796-9811
Fax Number	:

Provider Business Practice Location Address
First Line	:	10838 KINGS RD
Second Line	:	OFFICE 3134
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-6070
Country	:	US
Telephone Number	:	843-796-9811
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CHERYL LYNN KALIN
Credential	:
Telephone Number	:	843-796-9811

Provider Enumeration Date	:	05/04/2014
Last Update Date	:	05/04/2014

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