MEDICARE: MUNA AHMED ABDILLAHI

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	:	1740021070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUNA AHMED ABDILLAHI

Provider Business Mailing Address
First Line	:	3307 W LEODRA LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-5246
Country	:	US
Telephone Number	:	651-443-0323
Fax Number	:

Provider Business Practice Location Address
First Line	:	3307 W LEODRA LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-5246
Country	:	US
Telephone Number	:	651-443-0323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2024
Last Update Date	:	06/19/2024

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