MEDICARE: SOLOMON VALLEY TRANSPORTATION, 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1558973339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLOMON VALLEY TRANSPORTATION, INC.

Provider Business Mailing Address
First Line	:	PO BOX 412
Second Line	:
City	:	BELOIT
State	:	KS
Zip	:	67420-0412
Country	:	US
Telephone Number	:	785-738-9501
Fax Number	:	785-738-9503

Provider Business Practice Location Address
First Line	:	400 W 8TH ST
Second Line	:
City	:	BELOIT
State	:	KS
Zip	:	67420-1605
Country	:	US
Telephone Number	:	785-738-9501
Fax Number	:	785-738-9503

Authorized Official
Title or Position	:	BOARD SECRETARY
Name	:	LEANNE EILERT
Credential	:
Telephone Number	:	785-738-9501

Provider Enumeration Date	:	08/21/2020
Last Update Date	:	08/21/2020

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