MEDICARE: TAYLORED2GO 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	251E00000X	Home Health Agency
2	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1427895507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAYLORED2GO TRANSPORTATION, LLC

Provider Business Mailing Address
First Line	:	5015 GREENSIDE DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-6140
Country	:	US
Telephone Number	:	317-457-2947
Fax Number	:

Provider Business Practice Location Address
First Line	:	5015 GREENSIDE DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-6140
Country	:	US
Telephone Number	:	317-457-2947
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	VERONICA HOSKINS
Credential	:
Telephone Number	:	463-999-5656

Provider Enumeration Date	:	07/15/2024
Last Update Date	:	07/15/2024

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