MEDICARE: 1HAB TRANSPORTATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	342000000X	Transportation Network Company
2	343800000X	Secured Medical Transport (VAN)
3	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1306628359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1HAB TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	2309 TUDOR DR APT 3809
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-5859
Country	:	US
Telephone Number	:	817-658-1772
Fax Number	:

Provider Business Practice Location Address
First Line	:	2309 TUDOR DR APT 3809
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-5859
Country	:	US
Telephone Number	:	817-658-1772
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	SAMUEL ABRAHA
Credential	:
Telephone Number	:	817-658-1772

Provider Enumeration Date	:	10/16/2023
Last Update Date	:	10/24/2023

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