=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992110506
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAREPLUS TRANSPORTS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2014
-----------------------------------------------------
Last Update Date | 06/23/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 719 GRAFTON STREET
-----------------------------------------------------
City | SHREWSBURY
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01545
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-696-9327
-----------------------------------------------------
Fax | 508-304-3850
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 719 GRAFTON STREET
-----------------------------------------------------
City | SHREWSBURY
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01545
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-696-9327
-----------------------------------------------------
Fax | 508-304-3850
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. JASON KATRAGJINI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 774-696-9327
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 347C00000X
-----------------------------------------------------
Taxonomy Name | Private Vehicle
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------