MEDICARE: ELEVATED TRANSPORTATION SERVICES 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	:	1487318390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVATED TRANSPORTATION SERVICES LLC

Provider Business Mailing Address
First Line	:	6730 LA PUENTE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-1127
Country	:	US
Telephone Number	:	917-780-9406
Fax Number	:

Provider Business Practice Location Address
First Line	:	6730 LA PUENTE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-1127
Country	:	US
Telephone Number	:	917-780-9406
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AANU JOSEPH OLASUNKANMI
Credential	:
Telephone Number	:	917-780-9406

Provider Enumeration Date	:	10/26/2021
Last Update Date	:	03/30/2022

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Directions to “ELEVATED TRANSPORTATION SERVICES LLC ” Practice Location

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