MEDICARE: TO & FRO TRANSPORT 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	172A00000X	Driver

General Provider Information

NPI Number	:	1538654264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TO & FRO TRANSPORT LLC.

Provider Business Mailing Address
First Line	:	827 ASTRO CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-4775
Country	:	US
Telephone Number	:	702-609-6195
Fax Number	:

Provider Business Practice Location Address
First Line	:	827 ASTRO CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-4775
Country	:	US
Telephone Number	:	702-609-6195
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. TERHAIN WOODS
Credential	:
Telephone Number	:	702-606-6195

Provider Enumeration Date	:	06/26/2018
Last Update Date	:	06/26/2018

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