MEDICARE: ACCESS TRANSPORT, 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)		OH

General Provider Information

NPI Number	:	1508227000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS TRANSPORT, LLC

Provider Business Mailing Address
First Line	:	1725 E 3RD ST
Second Line	:	SUITE 1
City	:	DAYTON
State	:	OH
Zip	:	45403-1850
Country	:	US
Telephone Number	:	937-672-9988
Fax Number	:	855-811-8161

Provider Business Practice Location Address
First Line	:	1725 E 3RD ST
Second Line	:	SUITE 1
City	:	DAYTON
State	:	OH
Zip	:	45403-1850
Country	:	US
Telephone Number	:	937-672-9988
Fax Number	:	855-811-8161

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL D BIGGS
Credential	:
Telephone Number	:	937-672-9988

Provider Enumeration Date	:	03/10/2016
Last Update Date	:	03/10/2016

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