MEDICARE: ADDIS 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	:	1457288698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADDIS TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	2925 QUEEN CITY AVE APT 1
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2522
Country	:	US
Telephone Number	:	480-604-0184
Fax Number	:

Provider Business Practice Location Address
First Line	:	2925 QUEEN CITY AVE APT 1
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2522
Country	:	US
Telephone Number	:	480-604-0184
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	YOHANNES DEMISSE
Credential	:
Telephone Number	:	480-604-0184

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “ADDIS TRANSPORTATION LLC ” Practice Location

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