MEDICARE: ABU TRANSPORTATION 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)

General Provider Information

NPI Number	:	1184316036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABU TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	3417 W ALTA VISTA RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-5467
Country	:	US
Telephone Number	:	480-915-5781
Fax Number	:

Provider Business Practice Location Address
First Line	:	3417 W ALTA VISTA RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-5467
Country	:	US
Telephone Number	:	630-517-8859
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	YESHI MEKONNEN
Credential	:
Telephone Number	:	630-506-0450

Provider Enumeration Date	:	05/22/2023
Last Update Date	:	05/22/2023

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Directions to “ABU TRANSPORTATION LLC ” Practice Location

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