MEDICARE: HALI EXPRESS TRANSPORTATION

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	:	1033663687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALI EXPRESS TRANSPORTATION

Provider Business Mailing Address
First Line	:	13227 OUTLOOK ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66209-4022
Country	:	US
Telephone Number	:	913-713-5689
Fax Number	:	913-766-1867

Provider Business Practice Location Address
First Line	:	3024 WABASH AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64109-2172
Country	:	US
Telephone Number	:	913-713-5689
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	MR. TAMBA L HALI
Credential	:
Telephone Number	:	913-713-5689

Provider Enumeration Date	:	08/12/2016
Last Update Date	:	08/12/2016

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