MEDICARE: MKYAS 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)
2	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1629753017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MKYAS TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	8401 SKILLMAN ST APT 2073
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-1808
Country	:	US
Telephone Number	:	210-724-1899
Fax Number	:

Provider Business Practice Location Address
First Line	:	8401 SKILLMAN ST APT 2073
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-1808
Country	:	US
Telephone Number	:	210-724-1899
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FIYORI G HAGOS
Credential	:
Telephone Number	:	210-724-1899

Provider Enumeration Date	:	06/21/2023
Last Update Date	:	07/03/2023

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Directions to “MKYAS TRANSPORTATION LLC ” Practice Location

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