MEDICARE: EMPOWERLIFE TRANSPORTATION SERVICES 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	:	1326630427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWERLIFE TRANSPORTATION SERVICES LLC

Provider Business Mailing Address
First Line	:	3217 COMMANDER SHEPARD BLVD STE 2B
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-1598
Country	:	US
Telephone Number	:	757-790-6475
Fax Number	:

Provider Business Practice Location Address
First Line	:	3217 COMMANDER SHEPARD BLVD STE 2B
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-1598
Country	:	US
Telephone Number	:	757-790-6475
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NAJMAH CLARKE
Credential	:
Telephone Number	:	757-790-6475

Provider Enumeration Date	:	02/09/2021
Last Update Date	:	02/09/2021

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