MEDICARE: SOUTH BRONX TRANSPORTATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	343800000X	Secured Medical Transport (VAN)
2	347C00000X	Private Vehicle
3	344600000X	Taxi

General Provider Information

NPI Number	:	1669148078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH BRONX TRANSPORTATION

Provider Business Mailing Address
First Line	:	250 BROOK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10454-2637
Country	:	US
Telephone Number	:	347-590-7005
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 BROOK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10454-2637
Country	:	US
Telephone Number	:	347-590-7005
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EDWIDGE JEAN-BAPTISTE
Credential	:
Telephone Number	:	347-636-6395

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	08/17/2021

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Directions to “SOUTH BRONX TRANSPORTATION ” Practice Location

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