MEDICARE: SAFERIDE TRANSPORT 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	172A00000X	Driver
2	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1538988241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFERIDE TRANSPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	3197 CESAR CHAVEZ
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-4722
Country	:	US
Telephone Number	:	415-304-2927
Fax Number	:

Provider Business Practice Location Address
First Line	:	3197 CESAR CHAVEZ
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-4722
Country	:	US
Telephone Number	:	415-304-2927
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. NELSON ALMUETE CATUDAN
Credential	:
Telephone Number	:	415-304-2927

Provider Enumeration Date	:	10/09/2024
Last Update Date	:	10/09/2024

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