MEDICARE: C G G INC DBA C G G AMBULETTE

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)		OH

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	:	1447465745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C G G INC DBA C G G AMBULETTE

Provider Business Mailing Address
First Line	:	8060 READING RD
Second Line	:	SUITE 3
City	:	CINCINNATI
State	:	OH
Zip	:	45237-1414
Country	:	US
Telephone Number	:	513-851-5300
Fax Number	:	513-851-3456

Provider Business Practice Location Address
First Line	:	8060 READING RD
Second Line	:	SUITE 3
City	:	CINCINNATI
State	:	OH
Zip	:	45237-1414
Country	:	US
Telephone Number	:	513-851-5300
Fax Number	:	513-851-3456

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. GLYNDA BENN
Credential	:
Telephone Number	:	513-851-5300

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	06/20/2008

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