MEDICARE: TTTRANSONE 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	:	1902675580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TTTRANSONE LLC

Provider Business Mailing Address
First Line	:	2432 W PEORIA AVE, SUITE 1006
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4727
Country	:	US
Telephone Number	:	480-543-8051
Fax Number	:

Provider Business Practice Location Address
First Line	:	2432 W PEORIA AVE, SUITE 1006
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4727
Country	:	US
Telephone Number	:	480-543-8051
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAHA MUSA TIBIN
Credential	:
Telephone Number	:	480-543-8051

Provider Enumeration Date	:	12/25/2023
Last Update Date	:	12/25/2023

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Directions to “TTTRANSONE LLC ” Practice Location

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