MEDICARE: AKACHI TRANSPORTATION, LLC,

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	171WV0202X	Vehicle Modifications Contractor
2	171W00000X	Contractor

General Provider Information

NPI Number	:	1700346657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKACHI TRANSPORTATION, LLC,

Provider Business Mailing Address
First Line	:	PO BOX 20052
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-0052
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3154 AUDUBON BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-5328
Country	:	US
Telephone Number	:	216-313-0644
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NGOZI ADIGWE
Credential	:
Telephone Number	:	216-313-0644

Provider Enumeration Date	:	03/25/2019
Last Update Date	:	03/25/2019

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Directions to “AKACHI TRANSPORTATION, LLC, ” Practice Location

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