MEDICARE: AYEWARD TRANSPORATION LOGISTICS AND TOWING

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	:	1609556711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AYEWARD TRANSPORATION LOGISTICS AND TOWING

Provider Business Mailing Address
First Line	:	5360 SONORA RD
Second Line	:
City	:	HODGENVILLE
State	:	KY
Zip	:	42748-9663
Country	:	US
Telephone Number	:	270-735-3679
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 MEADOW DR STE 5
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40218-1374
Country	:	US
Telephone Number	:	270-735-3679
Fax Number	:

Authorized Official
Title or Position	:	CHIEF ADMINISTRATIVE OFFICER
Name	:	MS. SPERLISHA AYENI
Credential	:
Telephone Number	:	270-735-3679

Provider Enumeration Date	:	07/24/2023
Last Update Date	:	07/24/2023

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