MEDICARE: EXPRESS TRANSIT

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	:	1023777943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESS TRANSIT

Provider Business Mailing Address
First Line	:	10115 FOREST LANDING DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-4060
Country	:	US
Telephone Number	:	704-361-7450
Fax Number	:

Provider Business Practice Location Address
First Line	:	10115 FOREST LANDING DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-4060
Country	:	US
Telephone Number	:	704-361-7450
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMED ISMAIL
Credential	:
Telephone Number	:	704-361-7450

Provider Enumeration Date	:	12/08/2021
Last Update Date	:	12/08/2021

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Directions to “EXPRESS TRANSIT ” Practice Location

Language	Start Address	Practice Location

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