MEDICARE: AT YOUR SERVICE TRANSPORT, 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)	10-75	FL

General Provider Information

NPI Number	:	1770658445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT YOUR SERVICE TRANSPORT, INC.

Provider Business Mailing Address
First Line	:	10001 NW 50TH ST
Second Line	:	SUITE 203H
City	:	SUNRISE
State	:	FL
Zip	:	33351-8061
Country	:	US
Telephone Number	:	954-323-4092
Fax Number	:	954-323-4221

Provider Business Practice Location Address
First Line	:	10001 NW 50TH ST
Second Line	:	SUITE 203H
City	:	SUNRISE
State	:	FL
Zip	:	33351-8061
Country	:	US
Telephone Number	:	954-323-4092
Fax Number	:	954-323-4221

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS MARCIA SYLVIAN PRINGLE
Credential	:	MBA
Telephone Number	:	954-632-6374

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	08/22/2020

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