MEDICARE: SAMUEL L YOYO

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	:	1417427204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL L YOYO

Provider Business Mailing Address
First Line	:	3505 NE 94TH TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64156-8905
Country	:	US
Telephone Number	:	816-769-8472
Fax Number	:	816-612-9904

Provider Business Practice Location Address
First Line	:	3505 NE 94TH TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64156-8905
Country	:	US
Telephone Number	:	816-769-8472
Fax Number	:	816-612-9904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2018
Last Update Date	:	12/05/2018

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Directions to “ SAMUEL L YOYO ” Practice Location

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