MEDICARE: NATIONAL TRANSPORT, INC

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)

General Provider Information

NPI Number	:	1447023882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL TRANSPORT, INC

Provider Business Mailing Address
First Line	:	1144 N HOUSTON LEVEE RD STE 103
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-7145
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1144 N HOUSTON LEVEE RD STE 103
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-7145
Country	:	US
Telephone Number	:	501-944-7074
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MOHAMMAD HAJJEH
Credential	:
Telephone Number	:	501-944-7074

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	11/18/2023

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