Healthcare Provider Details

I. General information

NPI: 1679934863
Provider Name (Legal Business Name): EXCHANGE UR CARE TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 28TH ST SE STE 700
GRAND RAPIDS MI
49508-1313
US

IV. Provider business mailing address

865 28TH ST SE STE 700
GRAND RAPIDS MI
49508-1313
US

V. Phone/Fax

Practice location:
  • Phone: 616-272-3117
  • Fax: 616-350-9889
Mailing address:
  • Phone: 616-272-3117
  • Fax: 616-350-9889

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: LATRICIA JOYCE LOMAX
Title or Position: OWNER/ OPERATOR
Credential:
Phone: 616-893-3113