MEDICARE: CRYSTAL REWA

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)		MI

General Provider Information

NPI Number	:	1558218503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL REWA

Provider Business Mailing Address
First Line	:	3745 RICHARDSON AVE
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49442-6628
Country	:	US
Telephone Number	:	989-326-7693
Fax Number	:	989-502-8005

Provider Business Practice Location Address
First Line	:	3745 RICHARDSON AVE
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49442-6628
Country	:	US
Telephone Number	:	989-326-7693
Fax Number	:	989-502-8005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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Directions to “ CRYSTAL REWA ” Practice Location

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