MEDICARE: FAIRWAY CAR SERVICE 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	344600000X	Taxi	B02415	NY

General Provider Information

NPI Number	:	1881988707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRWAY CAR SERVICE INC

Provider Business Mailing Address
First Line	:	1466 ST PETERS AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461
Country	:	US
Telephone Number	:	718-409-4400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1466 SAINT PETERS AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-3304
Country	:	US
Telephone Number	:	718-409-4400
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	FRANKLIN DEJESUS
Credential	:
Telephone Number	:	347-242-4662

Provider Enumeration Date	:	06/08/2011
Last Update Date	:	06/08/2011

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Directions to “FAIRWAY CAR SERVICE INC ” Practice Location

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