MEDICARE: SAFE MEDICAL 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
1	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1902430838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFE MEDICAL TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	5601 SEMINARY RD APT 1313N
Second Line	:
City	:	FALLS CHUCH
State	:	VA
Zip	:	22041
Country	:	US
Telephone Number	:	571-458-9227
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 SEMINARY RD APT 1313N
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041-2999
Country	:	US
Telephone Number	:	571-458-9227
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANGER
Name	:	MR. EPHREM GEBREMICHAEL MDEHEN
Credential	:
Telephone Number	:	571-458-9227

Provider Enumeration Date	:	02/29/2020
Last Update Date	:	03/03/2020

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