MEDICARE: PALM'S TRANSIT 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)

General Provider Information

NPI Number	:	1538710546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM'S TRANSIT LLC

Provider Business Mailing Address
First Line	:	6410 BUSCH BLVD APT 479
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-1822
Country	:	US
Telephone Number	:	614-966-5764
Fax Number	:

Provider Business Practice Location Address
First Line	:	6410 BUSCH BLVD APT 479
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-1822
Country	:	US
Telephone Number	:	614-966-5764
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. KOFI ASAMOAH
Credential	:
Telephone Number	:	614-966-5764

Provider Enumeration Date	:	09/23/2019
Last Update Date	:	09/23/2019

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Directions to “PALM'S TRANSIT LLC ” Practice Location

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