MEDICARE: MEDITRANS XPRESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171W00000X	Contractor
2	342000000X	Transportation Network Company
3	343800000X	Secured Medical Transport (VAN)
4	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1639957533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDITRANS XPRESS

Provider Business Mailing Address
First Line	:	7301 TRIMBLE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76134-4639
Country	:	US
Telephone Number	:	918-800-1178
Fax Number	:

Provider Business Practice Location Address
First Line	:	7301 TRIMBLE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76134-4639
Country	:	US
Telephone Number	:	188-001-1789
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAJUANA GIVENS
Credential	:
Telephone Number	:	219-359-0796

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	10/02/2023

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Directions to “MEDITRANS XPRESS ” Practice Location

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