MEDICARE: REALIZABLE

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)
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1679307821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REALIZABLE

Provider Business Mailing Address
First Line	:	1351 BILOXI DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-2405
Country	:	US
Telephone Number	:	513-692-0078
Fax Number	:

Provider Business Practice Location Address
First Line	:	1580 COMPTON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-3428
Country	:	US
Telephone Number	:	330-880-7714
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	QUINETTA TUBBS
Credential	:
Telephone Number	:	513-692-0078

Provider Enumeration Date	:	08/29/2024
Last Update Date	:	08/29/2024

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Directions to “REALIZABLE ” Practice Location

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