MEDICARE: ICARE TRANSPORT SOLUTIONS 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)
2	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1396481511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ICARE TRANSPORT SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	6034 LAKEFRONT ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78222-3426
Country	:	US
Telephone Number	:	210-427-9756
Fax Number	:

Provider Business Practice Location Address
First Line	:	2361 AUSTIN HWY STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-1982
Country	:	US
Telephone Number	:	210-968-7932
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CLEMENT A NGANIZI
Credential	:
Telephone Number	:	210-968-7932

Provider Enumeration Date	:	05/10/2022
Last Update Date	:	06/08/2022

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Directions to “ICARE TRANSPORT SOLUTIONS LLC ” Practice Location

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