MEDICARE: CAPITAL TRANS GROUP INC

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	:	1922819283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPITAL TRANS GROUP INC

Provider Business Mailing Address
First Line	:	12 PEARL ST
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11581-2832
Country	:	US
Telephone Number	:	718-500-6542
Fax Number	:	516-300-0390

Provider Business Practice Location Address
First Line	:	12 PEARL ST
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11581-2832
Country	:	US
Telephone Number	:	718-500-6542
Fax Number	:	516-300-0390

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	LASHA CHUNASHVILI
Credential	:
Telephone Number	:	718-500-6542

Provider Enumeration Date	:	01/16/2025
Last Update Date	:	01/16/2025

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