MEDICARE: FOUR HEARTS MOBILITY 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1669338471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUR HEARTS MOBILITY SERVICES LLC

Provider Business Mailing Address
First Line	:	3526 HUMPHREY ST FL A
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-2723
Country	:	US
Telephone Number	:	703-282-9032
Fax Number	:

Provider Business Practice Location Address
First Line	:	3526 HUMPHREY ST FL A
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-2723
Country	:	US
Telephone Number	:	703-282-9032
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	FETIYA ABAMECHA ABAFOGI
Credential	:
Telephone Number	:	703-282-9032

Provider Enumeration Date	:	12/25/2025
Last Update Date	:	12/25/2025

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