MEDICARE: AJ MEDTRANS

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	:	1457086852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJ MEDTRANS

Provider Business Mailing Address
First Line	:	5151 N 95TH AVE APT 3013
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85305-3067
Country	:	US
Telephone Number	:	347-525-3806
Fax Number	:

Provider Business Practice Location Address
First Line	:	5151 N 95TH AVE APT 3013
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85305-3067
Country	:	US
Telephone Number	:	347-525-3806
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ADAM BRAHIMAJ
Credential	:
Telephone Number	:	347-525-3806

Provider Enumeration Date	:	07/19/2022
Last Update Date	:	07/19/2022

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