MEDICARE: EASYMED TRANSPORT

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	:	1730986969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASYMED TRANSPORT

Provider Business Mailing Address
First Line	:	2302 PEACH OAK XING
Second Line	:
City	:	MANVEL
State	:	TX
Zip	:	77578-4157
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2302 PEACH OAK XING
Second Line	:
City	:	MANVEL
State	:	TX
Zip	:	77578-4157
Country	:	US
Telephone Number	:	702-684-0083
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ANDARGACHEW SEYOUM
Credential	:
Telephone Number	:	702-684-0083

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	03/05/2025

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Directions to “EASYMED TRANSPORT ” Practice Location

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