MEDICARE: RAFI TRANSPORT 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	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1336920123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAFI TRANSPORT LLC

Provider Business Mailing Address
First Line	:	6334 SHADY BROOK LN APT 2152
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-1429
Country	:	US
Telephone Number	:	214-682-4313
Fax Number	:

Provider Business Practice Location Address
First Line	:	6334 SHADY BROOK LN APT 2152
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-1429
Country	:	US
Telephone Number	:	214-682-4313
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	SAMRAWIT KASSA
Credential	:
Telephone Number	:	214-682-4313

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	10/09/2023

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Directions to “RAFI TRANSPORT LLC ” Practice Location

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