MEDICARE: L&L COMPASSIONATE & DEPENDABLE SENIOR TRANSPORTATION SERVICE

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	164W00000X	Licensed Practical Nurse
2	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1861162745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L&L COMPASSIONATE & DEPENDABLE SENIOR TRANSPORTATION SERVICE

Provider Business Mailing Address
First Line	:	1215 W 3RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-1532
Country	:	US
Telephone Number	:	216-443-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 W 3RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-1532
Country	:	US
Telephone Number	:	216-443-6000
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LOREAL TRIGG
Credential	:	LPN
Telephone Number	:	216-303-4144

Provider Enumeration Date	:	09/14/2021
Last Update Date	:	01/18/2022

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