MEDICARE: ADMIRAL MEDICAL TRANSPORTATION

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	3416L0300X	Land Ambulance

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	:	1912270950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADMIRAL MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	1422 E LIVINGSTON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2922
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1422 E LIVINGSTON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2922
Country	:	US
Telephone Number	:	614-271-1001
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMED MOHAMED
Credential	:
Telephone Number	:	614-271-1001

Provider Enumeration Date	:	02/22/2012
Last Update Date	:	02/22/2012

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Directions to “ADMIRAL MEDICAL TRANSPORTATION ” Practice Location

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