MEDICARE: JOE BARNES NON EMERGENCY TRANSP

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)	1582	AL

General Provider Information

NPI Number	:	1861796047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE BARNES NON EMERGENCY TRANSP

Provider Business Mailing Address
First Line	:	3216 ETHEL AVE
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31906-1128
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3216 ETHEL AVE
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31906-1128
Country	:	US
Telephone Number	:	706-681-9256
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2011
Last Update Date	:	01/03/2011

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