MEDICARE: SHAWANA GEORGE

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)	008934738

General Provider Information

NPI Number	:	1184420796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWANA GEORGE

Provider Business Mailing Address
First Line	:	213 GRIMSBY ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-3812
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 GRIMSBY ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-3812
Country	:	US
Telephone Number	:	337-591-2401
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2025
Last Update Date	:	02/24/2025

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Directions to “ SHAWANA GEORGE ” Practice Location

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