MEDICARE: ANNA MAE PRICE

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)	27-2302336	OH

General Provider Information

NPI Number	:	1699091538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA MAE PRICE

Provider Business Mailing Address
First Line	:	11313 TEMBLETT AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44108-2666
Country	:	US
Telephone Number	:	216-326-1865
Fax Number	:	216-268-5768

Provider Business Practice Location Address
First Line	:	11313 TEMBLETT AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44108-2666
Country	:	US
Telephone Number	:	216-326-1865
Fax Number	:	216-268-5768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2010
Last Update Date	:	04/16/2010

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Directions to “ ANNA MAE PRICE ” Practice Location

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