MEDICARE: AMAYAH 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	:	1083278857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAYAH LLC

Provider Business Mailing Address
First Line	:	2554 THREE WILLOWS CT
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4023
Country	:	US
Telephone Number	:	804-325-9539
Fax Number	:

Provider Business Practice Location Address
First Line	:	2554 THREE WILLOWS CT
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4023
Country	:	US
Telephone Number	:	804-325-9539
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMMANUEL BEREKET HAGOS
Credential	:
Telephone Number	:	804-325-9539

Provider Enumeration Date	:	04/27/2019
Last Update Date	:	04/27/2019

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Directions to “AMAYAH LLC ” Practice Location

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