MEDICARE: L-J-L TRUCKING INC.

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	333300000X	Emergency Response System Companies	11203	PA
2	343900000X	Non-emergency Medical Transport (VAN)	A-00112962	PA
3	341600000X	Ambulance	11203	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	590010965	OTHER	PA	RAILROAD MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	150075	OTHER	PA	UMWA PROVIDER NUMBER
2	226349	OTHER	PA	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1036516	OTHER	PA	GATEWAY HEALTH PLAN #

General Provider Information

NPI Number	:	1205826476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L-J-L TRUCKING INC.

Provider Business Mailing Address
First Line	:	1311 PHILADELPHIA AVE
Second Line	:
City	:	NORTHERN CAMBRIA
State	:	PA
Zip	:	15714-1181
Country	:	US
Telephone Number	:	814-948-6170
Fax Number	:	814-948-6184

Provider Business Practice Location Address
First Line	:	1311 PHILADELPHIA AVE
Second Line	:
City	:	NORTHERN CAMBRIA
State	:	PA
Zip	:	15714
Country	:	US
Telephone Number	:	814-948-6170
Fax Number	:	814-948-6184

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	LIN S YACHTIS
Credential	:
Telephone Number	:	814-948-6170

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	07/25/2023

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Directions to “L-J-L TRUCKING INC. ” Practice Location

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