MEDICARE: HAMMOND 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1538799549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMMOND MEDICAL TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	9111 INTERLINE AVE STE 3A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-1979
Country	:	US
Telephone Number	:	225-444-5592
Fax Number	:	225-444-5692

Provider Business Practice Location Address
First Line	:	9111 INTERLINE AVE STE 3A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-1979
Country	:	US
Telephone Number	:	225-444-5592
Fax Number	:	225-444-5692

Authorized Official
Title or Position	:	OWNER
Name	:	BRANDON HAMMOND
Credential	:
Telephone Number	:	225-444-5592

Provider Enumeration Date	:	01/17/2020
Last Update Date	:	07/09/2021

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