MEDICARE: ON TIME MEDICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	343900000X	Non-emergency Medical Transport (VAN)
4	3747A0650X	Attendant Care Provider

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841731775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ON TIME MEDICAL LLC

Provider Business Mailing Address
First Line	:	2549 CEDAR LAKES DR
Second Line	:
City	:	RIPLEY
State	:	WV
Zip	:	25271-6551
Country	:	US
Telephone Number	:	304-373-3145
Fax Number	:

Provider Business Practice Location Address
First Line	:	15160 SW 136TH ST UNIT 10
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-2664
Country	:	US
Telephone Number	:	304-373-3145
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HUGO RENE OLIVARES
Credential	:
Telephone Number	:	786-556-4466

Provider Enumeration Date	:	03/10/2017
Last Update Date	:	04/11/2022

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Directions to “ON TIME MEDICAL LLC ” Practice Location

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