MEDICARE: STARZZ TRANSPORTATION

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	:	1205497864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STARZZ TRANSPORTATION

Provider Business Mailing Address
First Line	:	3570 S 500 W
Second Line	:
City	:	SOUTH SALT LAKE
State	:	UT
Zip	:	84115-4236
Country	:	US
Telephone Number	:	385-535-3301
Fax Number	:

Provider Business Practice Location Address
First Line	:	3570 S 500 W
Second Line	:
City	:	SOUTH SALT LAKE
State	:	UT
Zip	:	84115-4236
Country	:	US
Telephone Number	:	385-535-3301
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOHN EVANS
Credential	:
Telephone Number	:	385-535-3301

Provider Enumeration Date	:	06/25/2019
Last Update Date	:	06/25/2019

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Directions to “STARZZ TRANSPORTATION ” Practice Location

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