MEDICARE: JIM TRANSPORTATION 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	:	1093568982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JIM TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	10705 N HARRISON ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-1523
Country	:	US
Telephone Number	:	816-908-8898
Fax Number	:

Provider Business Practice Location Address
First Line	:	10705 N HARRISON ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-1523
Country	:	US
Telephone Number	:	816-908-8898
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NAHAYO JOSEPH
Credential	:
Telephone Number	:	816-908-8898

Provider Enumeration Date	:	04/09/2024
Last Update Date	:	04/09/2024

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Directions to “JIM TRANSPORTATION LLC ” Practice Location

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