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General NPI Number Information
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NPI Number | 1619364270
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Entity Type | Organization
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Legal Business Name | MODIVCARE SOLUTIONS, LLC
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 5875 NW 163RD ST STE 203
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City | MIAMI LAKES
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State | FL
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Zip | 33014-5618
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Country | US
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Telephone | 800-698-8457
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Fax | 305-471-0443
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Provider Business Mailing Address
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Address Line | 1275 PEACHTREE ST NE 6TH FLOOR
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City | ATLANTA
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State | GA
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Zip | 30309-3580
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Country | US
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Telephone | 800-486-7647
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Fax | 404-888-5999
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Authorized Official
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Title or Position | PRESIDENT & CHIEF EXECUTIVE OFFICER
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Name | DANIEL GREENLEAF
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Credential |
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Telephone | 800-486-7647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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