MEDICARE: YELLOW CAB OF VIRGINIA BEACH INC.

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	344600000X	Taxi

General Provider Information

NPI Number	:	1447736681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YELLOW CAB OF VIRGINIA BEACH INC.

Provider Business Mailing Address
First Line	:	6053 PROVIDENCE RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-3815
Country	:	US
Telephone Number	:	757-460-0605
Fax Number	:	757-460-0622

Provider Business Practice Location Address
First Line	:	6053 PROVIDENCE RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-3815
Country	:	US
Telephone Number	:	757-460-0605
Fax Number	:	757-460-0622

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	LILLIAN I LUCASH
Credential	:
Telephone Number	:	757-460-0605

Provider Enumeration Date	:	07/11/2018
Last Update Date	:	07/11/2018

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