MEDICARE: GOING YOUR WAY 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	343900000X	Non-emergency Medical Transport (VAN)	2172457	OH

General Provider Information

NPI Number	:	1932540200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOING YOUR WAY MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	3371 CHELSEA DR
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1321
Country	:	US
Telephone Number	:	216-647-4513
Fax Number	:

Provider Business Practice Location Address
First Line	:	3371 CHELSEA DR
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1321
Country	:	US
Telephone Number	:	216-647-4513
Fax Number	:

Authorized Official
Title or Position	:	OWNER OPERATOR
Name	:	MRS. SAMICA LYNN SUMMERS BETHUNE
Credential	:
Telephone Number	:	216-647-4513

Provider Enumeration Date	:	07/15/2013
Last Update Date	:	07/15/2013

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Directions to “GOING YOUR WAY MEDICAL TRANSPORTATION ” Practice Location

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