MEDICARE: MOTOPOOLE EXPRESS 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	:	1962104000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTOPOOLE EXPRESS TRANSPORTATION 'LLC'

Provider Business Mailing Address
First Line	:	1425 10TH AVENUE EAST
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34208-2719
Country	:	US
Telephone Number	:	941-274-2611
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 10TH AVENUE EAST
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34208-2719
Country	:	US
Telephone Number	:	941-274-2611
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MARY H POOLE
Credential	:
Telephone Number	:	941-274-2611

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	03/29/2023

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