MEDICARE: RSE 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	341600000X	Ambulance	L2685	MI

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	:	1861733222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RSE TRANSPORTATION, LLC

Provider Business Mailing Address
First Line	:	14501 ABINGTON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48227-1407
Country	:	US
Telephone Number	:	313-835-2434
Fax Number	:	313-736-3562

Provider Business Practice Location Address
First Line	:	14501 ABINGTON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48227-1407
Country	:	US
Telephone Number	:	313-835-2434
Fax Number	:	313-736-3562

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. JONI JERENE EZIDORE
Credential	:
Telephone Number	:	313-835-2434

Provider Enumeration Date	:	03/11/2013
Last Update Date	:	03/11/2013

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Directions to “RSE TRANSPORTATION, LLC ” Practice Location

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