MEDICARE: ABUNDANCE CARE TRANSPORTATION 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)

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	:	1871185488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABUNDANCE CARE TRANSPORTATION SERVICES, LLC

Provider Business Mailing Address
First Line	:	3602 AMITE RIVER DR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-6358
Country	:	US
Telephone Number	:	318-382-2624
Fax Number	:

Provider Business Practice Location Address
First Line	:	3602 AMITE RIVER DR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-6358
Country	:	US
Telephone Number	:	318-382-2624
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KOURTNEI KORVETTA MORRIS
Credential	:
Telephone Number	:	318-382-2624

Provider Enumeration Date	:	02/04/2021
Last Update Date	:	02/04/2021

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