MEDICARE: CTG BUSINESS LLC

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	:	1003677139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CTG BUSINESS LLC

Provider Business Mailing Address
First Line	:	1036 DUNN AVE STE 4-227
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-6349
Country	:	US
Telephone Number	:	904-207-2913
Fax Number	:

Provider Business Practice Location Address
First Line	:	4708 W MARLBORO CIR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32206-6144
Country	:	US
Telephone Number	:	904-207-2913
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TOYA BAILEY
Credential	:
Telephone Number	:	904-207-2913

Provider Enumeration Date	:	01/16/2024
Last Update Date	:	01/16/2024

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