MEDICARE: ALLEN&SHAVER TRANSPORTATION SERVICES

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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1790929289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEN&SHAVER TRANSPORTATION SERVICES

Provider Business Mailing Address
First Line	:	4309 E 126TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-6307
Country	:	US
Telephone Number	:	216-339-8104
Fax Number	:	216-883-1492

Provider Business Practice Location Address
First Line	:	4309 E 126TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-6307
Country	:	US
Telephone Number	:	216-339-8104
Fax Number	:	216-883-1492

Authorized Official
Title or Position	:	TRANSPORTATION SERVICES
Name	:	CHICLELYN U ALLEN
Credential	:
Telephone Number	:	216-339-8104

Provider Enumeration Date	:	04/28/2009
Last Update Date	:	04/28/2009

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