MEDICARE: BIG STAR TRANSIT, 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	:	1033565999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIG STAR TRANSIT, LLC

Provider Business Mailing Address
First Line	:	4204 COLDWATER CREEK LN
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-7782
Country	:	US
Telephone Number	:	216-470-4926
Fax Number	:

Provider Business Practice Location Address
First Line	:	4204 COLDWATER CREEK LN
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-7782
Country	:	US
Telephone Number	:	216-470-4926
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER/ OWNER
Name	:	MRS. LATANYA BIGGERS
Credential	:	MBA
Telephone Number	:	216-470-4926

Provider Enumeration Date	:	05/10/2016
Last Update Date	:	05/10/2016

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