MEDICARE: ROVER TRANSPORTATION 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	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1417795600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROVER TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	9901 BRODIE LN STE 160 1022
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-5892
Country	:	US
Telephone Number	:	916-871-6080
Fax Number	:

Provider Business Practice Location Address
First Line	:	9901 BRODIE LN STE 160 1022
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-5892
Country	:	US
Telephone Number	:	916-871-6080
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DEVIN YOUNG
Credential	:
Telephone Number	:	916-871-6080

Provider Enumeration Date	:	07/19/2024
Last Update Date	:	07/28/2024

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Directions to “ROVER TRANSPORTATION LLC ” Practice Location

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