MEDICARE: ON TIME MEDICAL 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	343800000X	Secured Medical Transport (VAN)	189315	OH

General Provider Information

NPI Number	:	1407193568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ON TIME MEDICAL TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	11201 SHAKER BLVD STE 126
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3833
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11201 SHAKER BLVD STE 126
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3833
Country	:	US
Telephone Number	:	216-854-5030
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. SAMEH RAMAHI
Credential	:
Telephone Number	:	216-854-5030

Provider Enumeration Date	:	01/09/2013
Last Update Date	:	01/10/2013

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