MEDICARE: DARRIN EDELGLASS DBA QUALITY 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	344600000X	Taxi	03964225	NY

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	:	1285099838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DARRIN EDELGLASS DBA QUALITY TRANSPORTATION

Provider Business Mailing Address
First Line	:	PO BOX 273
Second Line	:
City	:	WHITE SULPHUR SPRINGS
State	:	NY
Zip	:	12787-0273
Country	:	US
Telephone Number	:	845-747-4386
Fax Number	:	845-747-4568

Provider Business Practice Location Address
First Line	:	3319 STATE ROUTE 52
Second Line	:
City	:	WHITE SULPHUR SPRINGS
State	:	NY
Zip	:	12787-0273
Country	:	US
Telephone Number	:	845-747-4386
Fax Number	:	845-747-4568

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DARRIN LOUIS EDELGLASS
Credential	:
Telephone Number	:	845-747-4386

Provider Enumeration Date	:	12/28/2015
Last Update Date	:	12/28/2015

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