MEDICARE: REKA CARE, 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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1831920990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REKA CARE, LLC

Provider Business Mailing Address
First Line	:	9170 SAGEWOOD DR APT 5306
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-2347
Country	:	US
Telephone Number	:	319-693-7990
Fax Number	:

Provider Business Practice Location Address
First Line	:	9170 SAGEWOOD DR APT 5306
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-2347
Country	:	US
Telephone Number	:	319-693-7990
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. TREVIS LUMBU KALUNGA
Credential	:
Telephone Number	:	319-693-7990

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	09/13/2024

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