MEDICARE: J AND B CAR AND LIMO SVC

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)	B02488	NY

General Provider Information

NPI Number	:	1346527652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J AND B CAR AND LIMO SVC

Provider Business Mailing Address
First Line	:	4214 GLENWOOD ROAD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210
Country	:	US
Telephone Number	:	718-708-6181
Fax Number	:	718-946-0865

Provider Business Practice Location Address
First Line	:	4214 GLENWOOD ROAD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210
Country	:	US
Telephone Number	:	718-708-6181
Fax Number	:	718-946-0865

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BORIS POLYAKOV
Credential	:
Telephone Number	:	917-572-3524

Provider Enumeration Date	:	11/15/2011
Last Update Date	:	11/15/2011

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