MEDICARE: NEMTPORT 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	:	1922847219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEMTPORT LLC

Provider Business Mailing Address
First Line	:	1862 ALICE WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-2806
Country	:	US
Telephone Number	:	916-947-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1862 ALICE WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-2806
Country	:	US
Telephone Number	:	916-947-9999
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	FARRUKH SALEEM
Credential	:
Telephone Number	:	916-947-9999

Provider Enumeration Date	:	05/24/2024
Last Update Date	:	05/24/2024

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Directions to “NEMTPORT LLC ” Practice Location

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