MEDICARE: VOYAGER TRANSPORT SERVICE 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)	MTB5866	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043376379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOYAGER TRANSPORT SERVICE LLC

Provider Business Mailing Address
First Line	:	3281 TULLAMORE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2979
Country	:	US
Telephone Number	:	216-321-3305
Fax Number	:	216-321-5362

Provider Business Practice Location Address
First Line	:	3281 TULLAMORE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2979
Country	:	US
Telephone Number	:	216-321-3305
Fax Number	:	216-321-5362

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. LOUIS C. MITCHELL
Credential	:
Telephone Number	:	216-548-9111

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	07/02/2009

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