MEDICARE: PURPLE 8 TRANSPORT, INC.

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	:	1184204935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURPLE 8 TRANSPORT, INC.

Provider Business Mailing Address
First Line	:	7221 GREEN MEADOW DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-6700
Country	:	US
Telephone Number	:	972-816-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	7221 GREEN MEADOW DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-6700
Country	:	US
Telephone Number	:	972-816-5700
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CRYSTAL J BURROWS
Credential	:
Telephone Number	:	972-816-5700

Provider Enumeration Date	:	04/14/2021
Last Update Date	:	04/14/2021

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