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NPI Code Detail

MEDICARE: EXPRESS TRANSPORTATION, LLC

MEDICARE: EXPRESS 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
1343900000XNon-emergency Medical Transport (VAN)1753996VA

General Provider Information

NPI Number : 1811416415
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXPRESS TRANSPORTATION, LLC
Provider Business Mailing Address
First Line : 6561 EDSALL RD
Second Line :
City : SPRINGFIELD
State : VA
Zip : 22151-4414
Country : US
Telephone Number : 571-320-3381
Fax Number :
Provider Business Practice Location Address
First Line : 6561 EDSALL RD
Second Line :
City : SPRINGFIELD
State : VA
Zip : 22151-4414
Country : US
Telephone Number : 571-320-3381
Fax Number : 703-813-6115
Authorized Official
Title or Position : OFFICER
Name : SYED N RAZA
Credential :
Telephone Number : 571-320-3381
Provider Enumeration Date : 09/14/2017
Last Update Date : 09/14/2017

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Directions to “EXPRESS TRANSPORTATION, LLC ” Practice Location

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