MEDICARE: INTERNATIONAL NON EMERGENCY TRANSPORTATION LLC

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)	3899	KY

General Provider Information

NPI Number	:	1598182982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNATIONAL NON EMERGENCY TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	1115 ROYAL GARDENS CT APT 3
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40214-4654
Country	:	US
Telephone Number	:	502-294-2528
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 ROYAL GARDENS CT APT 3
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40214-4654
Country	:	US
Telephone Number	:	502-294-2528
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. NOOR MOHAMED HASSAN
Credential	:	DMV
Telephone Number	:	502-294-2528

Provider Enumeration Date	:	03/24/2014
Last Update Date	:	03/27/2014

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