MEDICARE: DAMON T WOODALL

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)	RK778085	OH

General Provider Information

NPI Number	:	1437937364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAMON T WOODALL

Provider Business Mailing Address
First Line	:	6512 HARSHMANVILLE RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45424-3517
Country	:	US
Telephone Number	:	937-789-4655
Fax Number	:

Provider Business Practice Location Address
First Line	:	6512 HARSHMANVILLE RD
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-3517
Country	:	US
Telephone Number	:	937-789-4655
Fax Number	:

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

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	10/10/2025

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Directions to “ DAMON T WOODALL ” Practice Location

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