MEDICARE: INSPIRED BY LOVE 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	:	1427682798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSPIRED BY LOVE TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	4941 MAGELLAN AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45426-1483
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4941 MAGELLAN AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45426-1483
Country	:	US
Telephone Number	:	937-715-1567
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DEONNA POWELL
Credential	:
Telephone Number	:	937-715-1567

Provider Enumeration Date	:	02/26/2020
Last Update Date	:	02/26/2020

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