MEDICARE: XCLUSIVE TRANSPORTING 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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1023823176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	XCLUSIVE TRANSPORTING LLC

Provider Business Mailing Address
First Line	:	3871 REDWINE RD APT 8301
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30344-5892
Country	:	US
Telephone Number	:	404-499-4226
Fax Number	:

Provider Business Practice Location Address
First Line	:	3871 REDWINE RD APT 8301
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30344-5892
Country	:	US
Telephone Number	:	404-499-4226
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARIAH RICHARDSON
Credential	:
Telephone Number	:	404-499-4226

Provider Enumeration Date	:	02/07/2025
Last Update Date	:	02/07/2025

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