MEDICARE: SIOUXLAND REGIONAL TRANSIT SYSTEM

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	347B00000X	Bus	0116947	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205916426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIOUXLAND REGIONAL TRANSIT SYSTEM

Provider Business Mailing Address
First Line	:	1122 PIERCE ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51105-1077
Country	:	US
Telephone Number	:	712-279-6919
Fax Number	:	712-279-6920

Provider Business Practice Location Address
First Line	:	1122 PIERCE ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51105-1452
Country	:	US
Telephone Number	:	712-279-6919
Fax Number	:	712-279-6920

Authorized Official
Title or Position	:	OPERATION MANAGER
Name	:	MS. TERRY BREWER
Credential	:
Telephone Number	:	712-279-6919

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	11/23/2007

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Directions to “SIOUXLAND REGIONAL TRANSIT SYSTEM ” Practice Location

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