MEDICARE: J&T RELIABLE 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)

General Provider Information

NPI Number	:	1457137192
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J&T RELIABLE TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	3817 PRIMM ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-7730
Country	:	US
Telephone Number	:	314-899-0770
Fax Number	:

Provider Business Practice Location Address
First Line	:	1004 N SARAH ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-3130
Country	:	US
Telephone Number	:	314-899-0770
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSE PERRY JR.
Credential	:
Telephone Number	:	314-586-4526

Provider Enumeration Date	:	09/07/2023
Last Update Date	:	09/07/2023

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