MEDICARE: SWIFT WHEELS TRANSPORTATION SERVICES , 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)	W426777630927	MD

General Provider Information

NPI Number	:	1063952901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWIFT WHEELS TRANSPORTATION SERVICES , LLC

Provider Business Mailing Address
First Line	:	3018 LAKE FOREST DR
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-9051
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3018 LAKE FOREST DR
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-9051
Country	:	US
Telephone Number	:	443-839-6164
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	MRS. STACEY WALKER
Credential	:
Telephone Number	:	443-839-6164

Provider Enumeration Date	:	02/26/2017
Last Update Date	:	02/26/2017

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