MEDICARE: PREFERRED SENIOR 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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437717527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED SENIOR TRANSPORTATION, LLC

Provider Business Mailing Address
First Line	:	9335 ARLINGTON RD
Second Line	:
City	:	BROOKVILLE
State	:	OH
Zip	:	45309-9643
Country	:	US
Telephone Number	:	937-239-4385
Fax Number	:

Provider Business Practice Location Address
First Line	:	9335 ARLINGTON RD
Second Line	:
City	:	BROOKVILLE
State	:	OH
Zip	:	45309-9643
Country	:	US
Telephone Number	:	937-239-4385
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KELLY A BOHSE
Credential	:
Telephone Number	:	937-239-4385

Provider Enumeration Date	:	06/03/2019
Last Update Date	:	06/03/2019

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