MEDICARE: TRISTATE NEMT 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	:	1942973664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRISTATE NEMT SERVICES LLC

Provider Business Mailing Address
First Line	:	2840 QUEEN CITY AVE APT 3
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2542
Country	:	US
Telephone Number	:	513-301-8449
Fax Number	:

Provider Business Practice Location Address
First Line	:	2840 QUEEN CITY AVE APT 3
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2542
Country	:	US
Telephone Number	:	513-301-8449
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ASHLEY N KNOX
Credential	:
Telephone Number	:	513-301-8449

Provider Enumeration Date	:	07/28/2021
Last Update Date	:	07/28/2021

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