MEDICARE: EMPOWERMENT QUALITY CARE 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)
2	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437384302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWERMENT QUALITY CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	8535 CLIFF CAMERON DR STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-5909
Country	:	US
Telephone Number	:	704-717-7477
Fax Number	:	704-717-7457

Provider Business Practice Location Address
First Line	:	8535 CLIFF CAMERON DR STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-5909
Country	:	US
Telephone Number	:	704-717-7477
Fax Number	:	704-717-7457

Authorized Official
Title or Position	:	CEO
Name	:	MR. ANDRE REYNOLDS
Credential	:
Telephone Number	:	704-717-7477

Provider Enumeration Date	:	05/21/2009
Last Update Date	:	02/16/2022

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