MEDICARE: SAMARKAND TRANSPORTATION GROUP INC

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	:	1609675149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMARKAND TRANSPORTATION GROUP INC

Provider Business Mailing Address
First Line	:	70 E SUNRISE HWY STE 500
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11581-1233
Country	:	US
Telephone Number	:	718-839-4646
Fax Number	:

Provider Business Practice Location Address
First Line	:	626 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-4132
Country	:	US
Telephone Number	:	347-379-9332
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. TEMURJOM IBRAGIMOV
Credential	:
Telephone Number	:	718-839-4646

Provider Enumeration Date	:	03/08/2025
Last Update Date	:	03/08/2025

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