MEDICARE: PROACTIVE 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1760316277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROACTIVE TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	211 S 2ND ST STE 243
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37040-2207
Country	:	US
Telephone Number	:	931-713-0566
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 S 2ND ST STE 243
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37040-2207
Country	:	US
Telephone Number	:	931-713-0566
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	SHYMONIQUE BROWN
Credential	:
Telephone Number	:	931-266-5934

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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