MEDICARE: BEANE'S MEDICAL 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	343900000X	Non-emergency Medical Transport (VAN)	0200802462	TN

General Provider Information

NPI Number	:	1700055688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEANE'S MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	8258 AMBER SPRINGS CV
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-6725
Country	:	US
Telephone Number	:	901-737-6334
Fax Number	:	901-309-0799

Provider Business Practice Location Address
First Line	:	8258 AMBER SPRINGS CV
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-6725
Country	:	US
Telephone Number	:	901-737-6334
Fax Number	:	901-309-0799

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	MR. HAROLD BEANE JR.
Credential	:
Telephone Number	:	901-737-6334

Provider Enumeration Date	:	02/26/2008
Last Update Date	:	08/13/2008

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