MEDICARE: ON-TIME MEDICAL 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	:	1568156586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ON-TIME MEDICAL TRANSPORTATION INC.

Provider Business Mailing Address
First Line	:	2300 VINE ST APT 301
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-3115
Country	:	US
Telephone Number	:	816-768-0177
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 VINE ST APT 301
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-3115
Country	:	US
Telephone Number	:	816-768-0177
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT /CEO
Name	:	MR. LARRY D WILLS
Credential	:
Telephone Number	:	816-768-0177

Provider Enumeration Date	:	06/05/2023
Last Update Date	:	06/06/2023

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