MEDICARE: A-TEAM MOBILITY 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)	532149	AZ
2	344600000X	Taxi	532149	AZ
3	343900000X	Non-emergency Medical Transport (VAN)	377347	MN

General Provider Information

NPI Number	:	1043524572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A-TEAM MOBILITY LLC

Provider Business Mailing Address
First Line	:	1248 RUSSELL AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-3662
Country	:	US
Telephone Number	:	612-293-8294
Fax Number	:

Provider Business Practice Location Address
First Line	:	1248 RUSSELL AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-3662
Country	:	US
Telephone Number	:	612-293-8294
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/MEMBER
Name	:	MIYO MARCHON-MONTINEZ ALEXANDER
Credential	:
Telephone Number	:	612-529-9999

Provider Enumeration Date	:	07/26/2010
Last Update Date	:	09/06/2016

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Directions to “A-TEAM MOBILITY LLC ” Practice Location

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