MEDICARE: CITY EXPRESS 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	:	1528355468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY EXPRESS LLC

Provider Business Mailing Address
First Line	:	3503 PROVIDENCE GLEN DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-6059
Country	:	US
Telephone Number	:	614-264-9231
Fax Number	:

Provider Business Practice Location Address
First Line	:	3503 PROVIDENCE GLEN DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-6059
Country	:	US
Telephone Number	:	614-264-9231
Fax Number	:

Authorized Official
Title or Position	:	TRANSPORTATION
Name	:	HASSAN ABDI SHAFAD
Credential	:
Telephone Number	:	614-264-9231

Provider Enumeration Date	:	06/29/2011
Last Update Date	:	06/29/2011

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Directions to “CITY EXPRESS LLC ” Practice Location

Language	Start Address	Practice Location

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