Healthcare Provider Details

I. General information

NPI: 1396481511
Provider Name (Legal Business Name): ICARE TRANSPORT SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2361 AUSTIN HWY STE 102
SAN ANTONIO TX
78218-1982
US

IV. Provider business mailing address

6034 LAKEFRONT ST
SAN ANTONIO TX
78222-3426
US

V. Phone/Fax

Practice location:
  • Phone: 210-968-7932
  • Fax:
Mailing address:
  • Phone: 210-427-9756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CLEMENT A NGANIZI
Title or Position: OWNER
Credential:
Phone: 210-968-7932