MEDICARE: SB XPRESS TRANSPORTATION 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	:	1023801990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SB XPRESS TRANSPORTATION SERVICES LLC

Provider Business Mailing Address
First Line	:	12428 TAMARACK ST NW
Second Line	:
City	:	COON RAPIDS
State	:	MN
Zip	:	55448-1434
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12428 TAMARACK ST NW
Second Line	:
City	:	COON RAPIDS
State	:	MN
Zip	:	55448-1434
Country	:	US
Telephone Number	:	612-229-3636
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SOLUMIE BEATRICE GRIGGS
Credential	:
Telephone Number	:	612-229-3636

Provider Enumeration Date	:	05/23/2025
Last Update Date	:	05/23/2025

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