MEDICARE: SMART TRANS 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)

General Provider Information

NPI Number	:	1588232995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMART TRANS LLC

Provider Business Mailing Address
First Line	:	5401 E VAN BUREN ST UNIT 3054
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-3469
Country	:	US
Telephone Number	:	480-370-9661
Fax Number	:

Provider Business Practice Location Address
First Line	:	5401 E VAN BUREN ST UNIT 3054
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-3469
Country	:	US
Telephone Number	:	480-370-9661
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WARFA GELLE
Credential	:
Telephone Number	:	480-370-9461

Provider Enumeration Date	:	06/13/2021
Last Update Date	:	06/13/2021

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Directions to “SMART TRANS LLC ” Practice Location

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