Healthcare Provider Details

I. General information

NPI: 1912599747
Provider Name (Legal Business Name): MNS NON EMERGENCY MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2021
Last Update Date: 02/03/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1248 THE GROVE RD
ORANGE PARK FL
32073
US

IV. Provider business mailing address

1248 THE GROVE RD
ORANGE PARK FL
32073-3729
US

V. Phone/Fax

Practice location:
  • Phone: 904-296-1698
  • Fax:
Mailing address:
  • Phone: 912-571-4591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELLE L BURKE-PARKS
Title or Position: PRESIDENT
Credential:
Phone: 912-571-4591