MEDICARE: ASPEN MEDICAL 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	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1497345862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPEN MEDICAL TRANSPORTATION, LLC

Provider Business Mailing Address
First Line	:	6161 BUSCH BLVD STE 330
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-2558
Country	:	US
Telephone Number	:	614-333-5315
Fax Number	:	614-333-5378

Provider Business Practice Location Address
First Line	:	6161 BUSCH BLVD STE 330
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-2558
Country	:	US
Telephone Number	:	614-333-5315
Fax Number	:	614-333-5378

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	SHEIKUNA OMAR
Credential	:
Telephone Number	:	614-359-5769

Provider Enumeration Date	:	01/20/2021
Last Update Date	:	01/20/2021

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