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General NPI Number Information
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NPI Number | 1114448248
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Entity Type | Organization
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Legal Business Name | S.M.A.R.T. CARE TRANSPORTATION, LLC.
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 06/28/2017
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Provider Practice Location Address
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Address Line | 17847 BRETZ DR
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City | HOMEWOOD
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State | IL
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Zip | 60430-1954
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Country | US
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Telephone | 312-388-2869
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 71
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City | DOLTON
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State | IL
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Zip | 60419-0071
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEVON RYCRAW
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Credential |
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Telephone | 312-388-2869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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