MEDICARE: GLENWOOD CAR SERVICE INC

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	344600000X	Taxi	B02537	NY

General Provider Information

NPI Number	:	1518212257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLENWOOD CAR SERVICE INC

Provider Business Mailing Address
First Line	:	4214 GLENWOOD RD
Second Line	:	1ST FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2027
Country	:	US
Telephone Number	:	718-253-1212
Fax Number	:	718-703-1215

Provider Business Practice Location Address
First Line	:	4214 GLENWOOD RD
Second Line	:	1ST FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2027
Country	:	US
Telephone Number	:	718-253-1212
Fax Number	:	718-703-1215

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFF GROBMAN
Credential	:
Telephone Number	:	718-253-1212

Provider Enumeration Date	:	07/18/2012
Last Update Date	:	07/18/2012

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