MEDICARE: OVERFLOW AT YOUR SERVICES 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	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1588431738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OVERFLOW AT YOUR SERVICES LLC

Provider Business Mailing Address
First Line	:	8107 MANDERVILLE LN APT 1326
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4029
Country	:	US
Telephone Number	:	469-971-6573
Fax Number	:

Provider Business Practice Location Address
First Line	:	8107 MANDERVILLE LN APT 1326
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4029
Country	:	US
Telephone Number	:	469-971-6573
Fax Number	:

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MR. CHRIS FERNAND NININAHAZWE
Credential	:
Telephone Number	:	214-435-5184

Provider Enumeration Date	:	12/07/2023
Last Update Date	:	12/07/2023

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