MEDICARE: TEAM TRANSPORTATION RESOURCES, INC

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	376J00000X	Homemaker
2	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1023584711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEAM TRANSPORTATION RESOURCES, INC

Provider Business Mailing Address
First Line	:	3310 MORSE RD STE 105
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-6191
Country	:	US
Telephone Number	:	614-418-0073
Fax Number	:	614-478-3285

Provider Business Practice Location Address
First Line	:	3310 MORSE RD STE 105
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-6191
Country	:	US
Telephone Number	:	614-418-0073
Fax Number	:	614-478-3285

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ABDIFATAH MOHAMED MOHAMUD JR.
Credential	:
Telephone Number	:	614-418-0073

Provider Enumeration Date	:	10/19/2018
Last Update Date	:	10/19/2018

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Directions to “TEAM TRANSPORTATION RESOURCES, INC ” Practice Location

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