MEDICARE: SUNCORE TRANSPORT 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	:	1649025941
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNCORE TRANSPORT LLC

Provider Business Mailing Address
First Line	:	PO BOX 93261
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33804-3261
Country	:	US
Telephone Number	:	863-616-3546
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 E MAIN ST
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-4628
Country	:	US
Telephone Number	:	863-225-9555
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRIS LAUX
Credential	:
Telephone Number	:	863-616-3546

Provider Enumeration Date	:	04/19/2024
Last Update Date	:	01/27/2025

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Directions to “SUNCORE TRANSPORT LLC ” Practice Location

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