MEDICARE: VISION NATIOANAL 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1750099198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION NATIOANAL TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	PO BOX 336
Second Line	:
City	:	FOUNTAIN CITY
State	:	IN
Zip	:	47341-0336
Country	:	US
Telephone Number	:	765-969-0223
Fax Number	:

Provider Business Practice Location Address
First Line	:	408 N US HIGHWAY 27
Second Line	:
City	:	FOUNTAIN CITY
State	:	IN
Zip	:	47341-9409
Country	:	US
Telephone Number	:	765-969-0223
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JEREMIAH JORDAN KINNEY
Credential	:
Telephone Number	:	765-960-5699

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	11/14/2022

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