MEDICARE: JOE HANEY'S TRANSPORTATION SERVICES,LTD

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)	RM325707	OH

General Provider Information

NPI Number	:	1952712036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOE HANEY'S TRANSPORTATION SERVICES,LTD

Provider Business Mailing Address
First Line	:	1830 BURROUGHS DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-4416
Country	:	US
Telephone Number	:	937-572-4662
Fax Number	:	937-299-3040

Provider Business Practice Location Address
First Line	:	1830 BURROUGHS DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-4416
Country	:	US
Telephone Number	:	937-572-4662
Fax Number	:	937-299-3040

Authorized Official
Title or Position	:	CO OWNER
Name	:	BRENDA HANEY
Credential	:
Telephone Number	:	937-572-4662

Provider Enumeration Date	:	05/12/2014
Last Update Date	:	05/12/2014

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