MEDICARE: ONTIMETRANS 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)

General Provider Information

NPI Number	:	1477104115
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONTIMETRANS LLC

Provider Business Mailing Address
First Line	:	6809 FOREST HILLS DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4094
Country	:	US
Telephone Number	:	713-517-4318
Fax Number	:

Provider Business Practice Location Address
First Line	:	6809 FOREST HILLS DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4094
Country	:	US
Telephone Number	:	713-517-4318
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAHAMOUD JAMA
Credential	:
Telephone Number	:	713-517-4318

Provider Enumeration Date	:	09/24/2019
Last Update Date	:	09/24/2019

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