MEDICARE: LR & S AVIATION INC.

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	347E00000X	Transportation Broker

General Provider Information

NPI Number	:	1861856874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LR & S AVIATION INC.

Provider Business Mailing Address
First Line	:	3046 ENISGLEN DR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-2009
Country	:	US
Telephone Number	:	727-781-1198
Fax Number	:	727-786-0897

Provider Business Practice Location Address
First Line	:	3046 ENISGLEN DR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-2009
Country	:	US
Telephone Number	:	727-781-1198
Fax Number	:	727-786-0897

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARK JONES
Credential	:
Telephone Number	:	727-781-1198

Provider Enumeration Date	:	04/06/2016
Last Update Date	:	04/06/2016

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