MEDICARE: AUBURN MEDICAL TRANSPORT COMPANY, 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	:	1346698131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUBURN MEDICAL TRANSPORT COMPANY, INC.

Provider Business Mailing Address
First Line	:	1540 GRAY RD
Second Line	:
City	:	UNION SPRINGS
State	:	NY
Zip	:	13160-4100
Country	:	US
Telephone Number	:	315-237-2814
Fax Number	:	315-253-3166

Provider Business Practice Location Address
First Line	:	1540 GRAY RD
Second Line	:
City	:	UNION SPRINGS
State	:	NY
Zip	:	13160-4100
Country	:	US
Telephone Number	:	315-237-2814
Fax Number	:	315-253-3166

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PENNY L MINNOE
Credential	:
Telephone Number	:	315-237-2814

Provider Enumeration Date	:	06/02/2016
Last Update Date	:	06/02/2016

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