MEDICARE: AVELYN TRANSPORTATION 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	343900000X	Non-emergency Medical Transport (VAN)	599WDL	NV
2	343900000X	Non-emergency Medical Transport (VAN)	56D997	NV

General Provider Information

NPI Number	:	1568902815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVELYN TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	4980 VILLA ALTAMURA ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1747
Country	:	US
Telephone Number	:	702-517-3537
Fax Number	:	702-749-8869

Provider Business Practice Location Address
First Line	:	4980 VILLA ALTAMURA ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1747
Country	:	US
Telephone Number	:	702-517-3537
Fax Number	:	702-749-8869

Authorized Official
Title or Position	:	OWNER/DRIVER
Name	:	MRS. DENAIT T. ABAY
Credential	:
Telephone Number	:	702-517-3537

Provider Enumeration Date	:	03/06/2017
Last Update Date	:	03/06/2017

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Directions to “AVELYN TRANSPORTATION LLC ” Practice Location

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