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General NPI Number Information
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NPI Number | 1487302485
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Entity Type | Organization
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Legal Business Name | CARE-A-VAN TRANSPORT
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 209 S 20TH ST
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-4626
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Country | US
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Telephone | 870-225-8151
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2763
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City | WEST MEMPHIS
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State | AR
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Zip | 72303-2763
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Country | US
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Telephone | 870-225-8151
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WENDY LOVE
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Credential |
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Telephone | 870-225-8151
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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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