MEDICARE: TOP GUN 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	347C00000X	Private Vehicle
2	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1124734835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOP GUN TRANSIT LLC

Provider Business Mailing Address
First Line	:	3917 PATRIOT RIDGE CT
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-6459
Country	:	US
Telephone Number	:	919-780-2137
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 VANCE ST
Second Line	:
City	:	CLINTON
State	:	NC
Zip	:	28328-4038
Country	:	US
Telephone Number	:	984-289-3667
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIC WEST
Credential	:
Telephone Number	:	919-780-2137

Provider Enumeration Date	:	01/25/2023
Last Update Date	:	02/01/2023

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Directions to “TOP GUN TRANSIT LLC ” Practice Location

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