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General NPI Number Information
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NPI Number | 1750076402
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Entity Type | Organization
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Legal Business Name | TRUCARE NON EMERGENCY MEDICAL TRANSPORTATION OF JAX
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 5199 OAK BEND AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32257-6289
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Country | US
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Telephone | 904-703-6968
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Fax |
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Provider Business Mailing Address
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Address Line | 7643 GATE PKWY STE 104-352
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City | JACKSONVILLE
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State | FL
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Zip | 32256-3092
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Country | US
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Telephone | 844-205-2690
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHERYL FOWLER
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Credential |
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Telephone | 904-703-6968
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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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