MEDICARE: COMMUNITY FIRST

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)	RT479888	OH

General Provider Information

NPI Number	:	1952769309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY FIRST

Provider Business Mailing Address
First Line	:	5006 DIERKER RD APT B1
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-5224
Country	:	US
Telephone Number	:	614-400-9575
Fax Number	:

Provider Business Practice Location Address
First Line	:	5006 DIERKER RD APT B1
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-5224
Country	:	US
Telephone Number	:	614-400-9575
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHARLES R MOSS
Credential	:
Telephone Number	:	614-400-9575

Provider Enumeration Date	:	01/31/2016
Last Update Date	:	01/31/2016

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Directions to “COMMUNITY FIRST ” Practice Location

Language	Start Address	Practice Location

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