MEDICARE: AMIRA TRANSPORT 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	:	1437803293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMIRA TRANSPORT LLC

Provider Business Mailing Address
First Line	:	3774 GROVE ST STE J
Second Line	:
City	:	LEMON GROVE
State	:	CA
Zip	:	91945-1899
Country	:	US
Telephone Number	:	619-793-7625
Fax Number	:

Provider Business Practice Location Address
First Line	:	3774 GROVE ST STE J
Second Line	:
City	:	LEMON GROVE
State	:	CA
Zip	:	91945-1899
Country	:	US
Telephone Number	:	619-793-7625
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ADIL BINMOHAMED
Credential	:
Telephone Number	:	619-793-7625

Provider Enumeration Date	:	02/09/2022
Last Update Date	:	02/09/2022

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Directions to “AMIRA TRANSPORT LLC ” Practice Location

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