MEDICARE: MADISON KEY TRANSPORTATION

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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1679130181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MADISON KEY TRANSPORTATION

Provider Business Mailing Address
First Line	:	3530 GREEN CREST DR APT 531
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-4170
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3530 GREEN CREST DR APT 531
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-4170
Country	:	US
Telephone Number	:	504-320-5865
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	RAKEISHA HYNSON
Credential	:
Telephone Number	:	504-320-5865

Provider Enumeration Date	:	05/21/2019
Last Update Date	:	05/21/2019

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Directions to “MADISON KEY TRANSPORTATION ” Practice Location

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