Healthcare Provider Details

I. General information

NPI: 1417860685
Provider Name (Legal Business Name): JCARE TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 ROUNDS AVE APT 1
PROVIDENCE RI
02907-3572
US

IV. Provider business mailing address

83 ROUNDS AVE APT 1
PROVIDENCE RI
02907-3572
US

V. Phone/Fax

Practice location:
  • Phone: 347-459-1859
  • Fax:
Mailing address:
  • Phone: 347-459-1859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JANNEL M ANTOINE
Title or Position: CEO/DRIVER
Credential:
Phone: 347-459-1859