MEDICARE: UNIVERSAL CARRIER INC. DBA GOLDEN AGE AMBULETTE

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)		NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538359500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL CARRIER INC. DBA GOLDEN AGE AMBULETTE

Provider Business Mailing Address
First Line	:	1805 GRAVESEND NECK RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4510
Country	:	US
Telephone Number	:	718-646-4444
Fax Number	:	718-646-0600

Provider Business Practice Location Address
First Line	:	1805 GRAVESEND NECK RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4510
Country	:	US
Telephone Number	:	718-646-4444
Fax Number	:	718-646-0600

Authorized Official
Title or Position	:	SECRETARY
Name	:	MR. VLADIMIR KHANIN
Credential	:
Telephone Number	:	718-646-4444

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	07/26/2007

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