MEDICARE: PASSENGERS 1ST RESOURCE L.L.C.

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	342000000X	Transportation Network Company

General Provider Information

NPI Number	:	1588314520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASSENGERS 1ST RESOURCE L.L.C.

Provider Business Mailing Address
First Line	:	1638 SHENANDOAH AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-2706
Country	:	US
Telephone Number	:	513-952-7421
Fax Number	:

Provider Business Practice Location Address
First Line	:	1638 SHENANDOAH AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-2706
Country	:	US
Telephone Number	:	513-952-7421
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TANISHA UNDERWOOD
Credential	:
Telephone Number	:	513-952-7421

Provider Enumeration Date	:	03/24/2022
Last Update Date	:	03/24/2022

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