MEDICARE: ON TIME TRANSPORTATION SOLUTION CORP

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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1073204616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ON TIME TRANSPORTATION SOLUTION CORP

Provider Business Mailing Address
First Line	:	5425 DRINKARD DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-4622
Country	:	US
Telephone Number	:	314-443-7893
Fax Number	:

Provider Business Practice Location Address
First Line	:	5425 DRINKARD DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-4622
Country	:	US
Telephone Number	:	314-443-7893
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CHARLES DAVIS
Credential	:
Telephone Number	:	314-443-7893

Provider Enumeration Date	:	05/16/2023
Last Update Date	:	05/16/2023

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Directions to “ON TIME TRANSPORTATION SOLUTION CORP ” Practice Location

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