MEDICARE: AJ'S MEDICAL TRANSPORT 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	343900000X	Non-emergency Medical Transport (VAN)

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	:	1275681694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJ'S MEDICAL TRANSPORT INC.

Provider Business Mailing Address
First Line	:	13310 REEDLEY ST
Second Line	:
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-4022
Country	:	US
Telephone Number	:	818-781-5455
Fax Number	:	818-787-6768

Provider Business Practice Location Address
First Line	:	13310 REEDLEY ST
Second Line	:
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-4022
Country	:	US
Telephone Number	:	818-781-5455
Fax Number	:	818-787-6768

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. VIVIAN S RUIZ
Credential	:
Telephone Number	:	818-781-5455

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	08/22/2020

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