MEDICARE: GUNHILL TRANSPORTATION 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	:	1043914716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUNHILL TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	750 N SAINT PAUL ST STE 563224
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-3236
Country	:	US
Telephone Number	:	513-545-2682
Fax Number	:

Provider Business Practice Location Address
First Line	:	750 N SAINT PAUL ST STE 563224
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-3236
Country	:	US
Telephone Number	:	513-545-2682
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	PATIENCE TENDAI CHINHONDO
Credential	:
Telephone Number	:	513-545-2682

Provider Enumeration Date	:	03/28/2023
Last Update Date	:	03/28/2023

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