MEDICARE: NON-EMERGENCY 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)

General Provider Information

NPI Number	:	1851561401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NON-EMERGENCY TRANSPORTATION

Provider Business Mailing Address
First Line	:	6124 BRANDONWOOD LN
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46835-2512
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6124 BRANDONWOOD LN
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46835-2512
Country	:	US
Telephone Number	:	260-615-3517
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. NASER TAWFIK ELSWERKY
Credential	:
Telephone Number	:	260-615-3517

Provider Enumeration Date	:	03/10/2008
Last Update Date	:	03/10/2008

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Directions to “NON-EMERGENCY TRANSPORTATION ” Practice Location

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