MEDICARE: VINEYARD 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	:	1194670174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VINEYARD TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	8623 BEVERLY LN
Second Line	:
City	:	DUBLIN
State	:	CA
Zip	:	94568-1216
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8623 BEVERLY LN
Second Line	:
City	:	DUBLIN
State	:	CA
Zip	:	94568-1216
Country	:	US
Telephone Number	:	510-458-8610
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	ADEL HANNA
Credential	:
Telephone Number	:	510-458-8610

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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