MEDICARE: GOODHEARTS CARE SERVICES 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1902522303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOODHEARTS CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1495 MORSE RD STE 311
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-6438
Country	:	US
Telephone Number	:	614-598-4430
Fax Number	:	614-845-5575

Provider Business Practice Location Address
First Line	:	1495 MORSE RD STE 311
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-6438
Country	:	US
Telephone Number	:	614-598-4430
Fax Number	:	614-845-5575

Authorized Official
Title or Position	:	CEO /OWNER
Name	:	AWES H KOSHIN
Credential	:
Telephone Number	:	614-615-2858

Provider Enumeration Date	:	10/17/2022
Last Update Date	:	10/17/2022

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