MEDICARE: SPRINGS MEDICAL TRANSPORT 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	172A00000X	Driver

General Provider Information

NPI Number	:	1871378109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRINGS MEDICAL TRANSPORT LLC

Provider Business Mailing Address
First Line	:	2885 S CIRCLE DR # 2232
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4112
Country	:	US
Telephone Number	:	719-963-6299
Fax Number	:

Provider Business Practice Location Address
First Line	:	2885 S CIRCLE DR # 2232
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4112
Country	:	US
Telephone Number	:	719-963-6299
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOLIE KERR
Credential	:
Telephone Number	:	719-963-6299

Provider Enumeration Date	:	08/25/2023
Last Update Date	:	08/25/2023

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Directions to “SPRINGS MEDICAL TRANSPORT LLC ” Practice Location

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