MEDICARE: UNITEDLIFE TRANSIT 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	:	1780560128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITEDLIFE TRANSIT LLC

Provider Business Mailing Address
First Line	:	615 KIMBALL ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55432-1644
Country	:	US
Telephone Number	:	612-323-3132
Fax Number	:

Provider Business Practice Location Address
First Line	:	2817 ANTHONY LN S STE 313B
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-3254
Country	:	US
Telephone Number	:	612-238-0060
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CHUAN LIN VANG
Credential	:
Telephone Number	:	612-323-3132

Provider Enumeration Date	:	08/12/2025
Last Update Date	:	08/12/2025

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