MEDICARE: PRIORITY TRANSIT, 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	344600000X	Taxi
2	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033421458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIORITY TRANSIT, LLC

Provider Business Mailing Address
First Line	:	2336 E MAGNOLIA ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85034-6819
Country	:	US
Telephone Number	:	602-231-0102
Fax Number	:	602-621-4967

Provider Business Practice Location Address
First Line	:	2336 E MAGNOLIA ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85034-6819
Country	:	US
Telephone Number	:	602-231-0102
Fax Number	:	602-621-4967

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	JILL J GILLESPIE
Credential	:	CPA
Telephone Number	:	602-231-0102

Provider Enumeration Date	:	07/14/2010
Last Update Date	:	07/14/2010

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