MEDICARE: J&MTRANSPORTATION

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	:	1124566732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J&MTRANSPORTATION

Provider Business Mailing Address
First Line	:	8175 BLACK RIVER RD
Second Line	:
City	:	REMBERT
State	:	SC
Zip	:	29128-8634
Country	:	US
Telephone Number	:	803-720-4825
Fax Number	:

Provider Business Practice Location Address
First Line	:	8175 BLACK RIVER RD
Second Line	:
City	:	REMBERT
State	:	SC
Zip	:	29128-8634
Country	:	US
Telephone Number	:	803-720-4825
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOHNNY MCCLAIN
Credential	:
Telephone Number	:	803-720-4825

Provider Enumeration Date	:	02/02/2017
Last Update Date	:	02/02/2017

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Directions to “J&MTRANSPORTATION ” Practice Location

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