MEDICARE: PYRAMID EXPRESS SHUTTLE

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)	USDOT 1495699	IN

General Provider Information

NPI Number	:	1407048218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PYRAMID EXPRESS SHUTTLE

Provider Business Mailing Address
First Line	:	3762 N EMERSON AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-1738
Country	:	US
Telephone Number	:	317-591-1829
Fax Number	:	317-541-9681

Provider Business Practice Location Address
First Line	:	3762 N EMERSON AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-1738
Country	:	US
Telephone Number	:	317-591-1829
Fax Number	:	317-541-9681

Authorized Official
Title or Position	:	PROPREITOR
Name	:	MS. LONNIE S HITE WATTS
Credential	:
Telephone Number	:	317-591-1829

Provider Enumeration Date	:	08/15/2007
Last Update Date	:	08/15/2007

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Directions to “PYRAMID EXPRESS SHUTTLE ” Practice Location

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