MEDICARE: TOBI TRANSPORTATION

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)		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	:	1144728825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOBI TRANSPORTATION

Provider Business Mailing Address
First Line	:	14100 BARDWELL AVE
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-3704
Country	:	US
Telephone Number	:	216-212-1727
Fax Number	:

Provider Business Practice Location Address
First Line	:	14100 BARDWELL AVE
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-3704
Country	:	US
Telephone Number	:	216-212-1727
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BEATRICE JACKSON
Credential	:
Telephone Number	:	216-212-1727

Provider Enumeration Date	:	01/26/2018
Last Update Date	:	01/26/2018

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Directions to “TOBI TRANSPORTATION ” Practice Location

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