MEDICARE: HOOSIER TRANSPORT SERVICE INC

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)	68493	IN

General Provider Information

NPI Number	:	1982851713
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOOSIER TRANSPORT SERVICE INC

Provider Business Mailing Address
First Line	:	221 HICKORY AVE
Second Line	:
City	:	SALEM
State	:	IN
Zip	:	47167-7944
Country	:	US
Telephone Number	:	812-883-9341
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 CONNIE AVE
Second Line	:
City	:	SALEM
State	:	IN
Zip	:	47167-2305
Country	:	US
Telephone Number	:	812-883-9256
Fax Number	:	812-883-9204

Authorized Official
Title or Position	:	OWNER/ PRESIDENT
Name	:	MR. BRIAN SCOTT HEDRICK
Credential	:
Telephone Number	:	812-883-9256

Provider Enumeration Date	:	08/22/2008
Last Update Date	:	08/22/2008

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Directions to “HOOSIER TRANSPORT SERVICE INC ” Practice Location

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