MEDICARE: AASH MEDICAL 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)	LC001423528	MO

General Provider Information

NPI Number	:	1326572975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AASH MEDICAL TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	3830 N MULBERRY DR APT 4201
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64116-1889
Country	:	US
Telephone Number	:	612-735-8413
Fax Number	:	816-491-8434

Provider Business Practice Location Address
First Line	:	3830 N MULBERRY DR APT 4201
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64116-1889
Country	:	US
Telephone Number	:	612-735-8413
Fax Number	:	816-491-8434

Authorized Official
Title or Position	:	OWNER
Name	:	TARIQ M ABDULQADIR
Credential	:
Telephone Number	:	612-735-8413

Provider Enumeration Date	:	04/19/2017
Last Update Date	:	04/19/2017

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