MEDICARE: S A TRANSPORT LIMITED LIABILITY COMPANY

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	:	1841880499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S A TRANSPORT LIMITED LIABILITY COMPANY

Provider Business Mailing Address
First Line	:	3974 GRAHAMDALE CIR APT C
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38122-2306
Country	:	US
Telephone Number	:	347-221-8478
Fax Number	:

Provider Business Practice Location Address
First Line	:	3974 GRAHAMDALE CIR APT C
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38122-2306
Country	:	US
Telephone Number	:	347-221-8478
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	SAHID ADEJUMO
Credential	:
Telephone Number	:	347-221-8478

Provider Enumeration Date	:	01/18/2021
Last Update Date	:	01/18/2021

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Directions to “S A TRANSPORT LIMITED LIABILITY COMPANY ” Practice Location

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