MEDICARE: MERAKI TRANSPORT

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	:	1457828824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERAKI TRANSPORT

Provider Business Mailing Address
First Line	:	305 ENTERPRISE AVE
Second Line	:
City	:	MERLIN
State	:	OR
Zip	:	97532-9802
Country	:	US
Telephone Number	:	541-916-2520
Fax Number	:	541-916-8363

Provider Business Practice Location Address
First Line	:	305 ENTERPRISE AVE
Second Line	:
City	:	MERLIN
State	:	OR
Zip	:	97532-9802
Country	:	US
Telephone Number	:	541-916-2520
Fax Number	:	541-916-8363

Authorized Official
Title or Position	:	BUSINESS OFFICE MANAGER
Name	:	FELECIA N SHAW
Credential	:
Telephone Number	:	541-916-2520

Provider Enumeration Date	:	10/24/2018
Last Update Date	:	10/24/2018

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Directions to “MERAKI TRANSPORT ” Practice Location

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