MEDICARE: ZASTIK MEDICAL TRANSPORT

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	:	1669209235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZASTIK MEDICAL TRANSPORT

Provider Business Mailing Address
First Line	:	1362 RIDERWOOD AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-2628
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1362 RIDERWOOD AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-2628
Country	:	US
Telephone Number	:	626-756-7431
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ZACHARY E MONROY
Credential	:
Telephone Number	:	626-756-7431

Provider Enumeration Date	:	09/18/2024
Last Update Date	:	09/18/2024

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