MEDICARE: QUALIFIED MEDICAL TRANPORTATION

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	:	1588279012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALIFIED MEDICAL TRANPORTATION

Provider Business Mailing Address
First Line	:	16813 LIPTON AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-3619
Country	:	US
Telephone Number	:	216-760-4633
Fax Number	:

Provider Business Practice Location Address
First Line	:	3225 E 56TH PL
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44127-1301
Country	:	US
Telephone Number	:	216-760-4633
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LATIA RAMSEY
Credential	:
Telephone Number	:	216-760-4633

Provider Enumeration Date	:	09/11/2020
Last Update Date	:	07/05/2022

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Directions to “QUALIFIED MEDICAL TRANPORTATION ” Practice Location

Language	Start Address	Practice Location

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