MEDICARE: BEVERLY HILLS TRANSPORTATION, 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)		CA

General Provider Information

NPI Number	:	1275857377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEVERLY HILLS TRANSPORTATION, INC.

Provider Business Mailing Address
First Line	:	9350 WILSHIRE BLVD STE 204
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-3204
Country	:	US
Telephone Number	:
Fax Number	:	310-278-0107

Provider Business Practice Location Address
First Line	:	9350 WILSHIRE BLVD STE 204
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-3204
Country	:	US
Telephone Number	:	310-278-0102
Fax Number	:	310-278-0107

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FAINA NEVELEVA
Credential	:
Telephone Number	:	310-278-0102

Provider Enumeration Date	:	03/17/2010
Last Update Date	:	03/17/2010

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