MEDICARE: SAFCO 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)	LC001549838	MO

General Provider Information

NPI Number	:	1427530948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFCO LLC

Provider Business Mailing Address
First Line	:	4517 FERRER DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63129-3740
Country	:	US
Telephone Number	:	314-556-1704
Fax Number	:	314-329-6221

Provider Business Practice Location Address
First Line	:	4517 FERRER DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63129-3740
Country	:	US
Telephone Number	:	314-556-1704
Fax Number	:	314-329-6221

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EDILL OSMUN MAHAMMED
Credential	:
Telephone Number	:	314-556-1704

Provider Enumeration Date	:	08/31/2018
Last Update Date	:	08/31/2018

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Directions to “SAFCO LLC ” Practice Location

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