MEDICARE: ZIA MEDICAL TRANSPORTATION

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	:	1497205728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZIA MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	3924 CARLISLE BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-4504
Country	:	US
Telephone Number	:	505-881-2478
Fax Number	:

Provider Business Practice Location Address
First Line	:	3924 CARLISLE BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-4504
Country	:	US
Telephone Number	:	505-881-2478
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANIEL ABEYTA
Credential	:
Telephone Number	:	505-881-2478

Provider Enumeration Date	:	10/11/2016
Last Update Date	:	10/11/2016

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