MEDICARE: HANSHENSLEY, 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)
2	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1417733544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANSHENSLEY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 16736
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76162-0736
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6613 STOLTE LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-4657
Country	:	US
Telephone Number	:	682-716-9832
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. EUGUENS TOUSSAINT
Credential	:
Telephone Number	:	682-716-9832

Provider Enumeration Date	:	09/05/2023
Last Update Date	:	10/10/2023

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Directions to “HANSHENSLEY, LLC ” Practice Location

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