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NPI Code Detail

MEDICARE: THE OLE HOMEPLACE TRANSPORT INC.

MEDICARE: THE OLE HOMEPLACE 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
1343800000XSecured Medical Transport (VAN)3569KY
2347C00000XPrivate Vehicle3569KY
3343900000XNon-emergency Medical Transport (VAN)3569KY

General Provider Information

NPI Number : 1316263999
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE OLE HOMEPLACE TRANSPORT INC.
Provider Business Mailing Address
First Line : 113 CAMPBELLSVILLE ST
Second Line :
City : COLUMBIA
State : KY
Zip : 42728-1434
Country : US
Telephone Number : 270-384-0148
Fax Number :
Provider Business Practice Location Address
First Line : 113 CAMPBELLSVILLE ST
Second Line :
City : COLUMBIA
State : KY
Zip : 42728-1434
Country : US
Telephone Number : 270-384-0148
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : CARSON L MCCLOUD
Credential :
Telephone Number : 270-384-0148
Provider Enumeration Date : 04/08/2010
Last Update Date : 05/10/2010

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Directions to “THE OLE HOMEPLACE TRANSPORT INC. ” Practice Location

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