MEDICARE: CAUCASUS TRANSPORT 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	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1023973179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAUCASUS TRANSPORT LLC

Provider Business Mailing Address
First Line	:	2912 AVENUE X # 207
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2912 AVENUE X # 207
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1906
Country	:	US
Telephone Number	:	877-779-4077
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	ROMANI ONIANI
Credential	:
Telephone Number	:	252-420-2402

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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