Healthcare Provider Details

I. General information

NPI: 1386993012
Provider Name (Legal Business Name): ZIPCARE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

763 SOUTH NEW BALLAS RD SUITE 300
SAINT LOUIS MO
63141
US

IV. Provider business mailing address

763 S NEW BALLAS RD SUITE 300
SAINT LOUIS MO
63141-8704
US

V. Phone/Fax

Practice location:
  • Phone: 314-292-7302
  • Fax:
Mailing address:
  • Phone: 314-292-7302
  • 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: MRS. ANGELICA MONIQUE MARTIN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 314-292-7302