MEDICARE: CHAPPIES TRUCKING 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)	488222329	NY

General Provider Information

NPI Number	:	1134549611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAPPIES TRUCKING LLC

Provider Business Mailing Address
First Line	:	39 RIVERSIDE DR
Second Line	:
City	:	WOODBOURNE
State	:	NY
Zip	:	12788-5701
Country	:	US
Telephone Number	:	845-693-4511
Fax Number	:

Provider Business Practice Location Address
First Line	:	39 RIVERSIDE DR
Second Line	:
City	:	WOODBOURNE
State	:	NY
Zip	:	12788-5701
Country	:	US
Telephone Number	:	845-693-4511
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LUIS KAUFMAN
Credential	:
Telephone Number	:	845-693-4511

Provider Enumeration Date	:	04/23/2014
Last Update Date	:	04/23/2014

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