MEDICARE: SUPERIOR TRANSPORTATION ALLIANCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	174200000X	Meals Provider
2	332U00000X	Home Delivered Meals
3	342000000X	Transportation Network Company
4	343800000X	Secured Medical Transport (VAN)
5	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1497535496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPERIOR TRANSPORTATION ALLIANCE

Provider Business Mailing Address
First Line	:	5004 SAM RHYNE CT
Second Line	:
City	:	DALLAS
State	:	NC
Zip	:	28034-6400
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5004 SAM RHYNE CT
Second Line	:
City	:	DALLAS
State	:	NC
Zip	:	28034-6400
Country	:	US
Telephone Number	:	704-912-9561
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHANARA MINTZ
Credential	:
Telephone Number	:	704-912-9561

Provider Enumeration Date	:	10/05/2023
Last Update Date	:	10/16/2023

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Directions to “SUPERIOR TRANSPORTATION ALLIANCE ” Practice Location

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