MEDICARE: CINCY ELITE 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	:	1215790308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINCY ELITE TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	5426 EHRLING RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-1123
Country	:	US
Telephone Number	:	513-510-3838
Fax Number	:	513-731-6606

Provider Business Practice Location Address
First Line	:	5426 EHRLING RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-1123
Country	:	US
Telephone Number	:	513-510-3838
Fax Number	:	513-731-6606

Authorized Official
Title or Position	:	OWNER
Name	:	DEONNA BROWN
Credential	:
Telephone Number	:	513-510-3838

Provider Enumeration Date	:	02/01/2024
Last Update Date	:	02/01/2024

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