=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639787039
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | U S CARE TRANSPORTATION LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/21/2020
-----------------------------------------------------
Last Update Date | 07/21/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4220 S 164TH ST UNIT 102
-----------------------------------------------------
City | TUKWILA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98188-3296
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-203-4859
-----------------------------------------------------
Fax | 206-204-9302
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 13692
-----------------------------------------------------
City | DES MOINES
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98198-1010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. ALWALEED SIDAHMED
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 253-203-4859
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------