MEDICARE: DOUBLE PORTION PRODUCTION & TRANSPORTATION

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	:	1265868483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOUBLE PORTION PRODUCTION & TRANSPORTATION

Provider Business Mailing Address
First Line	:	3661 W WALNUT HILL LN
Second Line	:	APT 2145
City	:	IRVING
State	:	TX
Zip	:	75038-4044
Country	:	US
Telephone Number	:	214-705-4461
Fax Number	:

Provider Business Practice Location Address
First Line	:	3661 W WALNUT HILL LN
Second Line	:	APT 2145
City	:	IRVING
State	:	TX
Zip	:	75038-4044
Country	:	US
Telephone Number	:	214-705-4461
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MR. ELISHA SHAMUYARIRA
Credential	:
Telephone Number	:	214-705-4461

Provider Enumeration Date	:	09/19/2013
Last Update Date	:	09/19/2013

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Directions to “DOUBLE PORTION PRODUCTION & TRANSPORTATION ” Practice Location

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