MEDICARE: GO VAMO 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	342000000X	Transportation Network Company

General Provider Information

NPI Number	:	1568231942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GO VAMO TRANSPORT LLC

Provider Business Mailing Address
First Line	:	7534 EARNSHAW AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89179-1601
Country	:	US
Telephone Number	:	702-445-0675
Fax Number	:

Provider Business Practice Location Address
First Line	:	7534 EARNSHAW AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89179-1601
Country	:	US
Telephone Number	:	702-445-0675
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DONALD BISHOP
Credential	:
Telephone Number	:	702-445-0675

Provider Enumeration Date	:	12/27/2023
Last Update Date	:	12/27/2023

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