MEDICARE: TOTAL CARE EMS 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	:	1063105047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL CARE EMS LLC

Provider Business Mailing Address
First Line	:	13361 N 56TH ST
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33617-1161
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13361 N 56TH ST
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33617-1161
Country	:	US
Telephone Number	:	813-320-0400
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. QUAVER LAJAUNE WHITE
Credential	:
Telephone Number	:	813-320-0400

Provider Enumeration Date	:	05/26/2023
Last Update Date	:	06/23/2023

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