MEDICARE: ORBIT TRANSPORTATION, LLC

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)

General Provider Information

NPI Number	:	1376049023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORBIT TRANSPORTATION, LLC

Provider Business Mailing Address
First Line	:	304 PARK RIDGE DR
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39042-2942
Country	:	US
Telephone Number	:	504-220-8308
Fax Number	:	888-516-0579

Provider Business Practice Location Address
First Line	:	304 PARK RIDGE DR
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39042-2942
Country	:	US
Telephone Number	:	888-236-9565
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CORNELIUS MARSHALL
Credential	:
Telephone Number	:	504-220-8308

Provider Enumeration Date	:	04/02/2018
Last Update Date	:	04/02/2018

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