MEDICARE: HEALTHCAR NON-EMERGENCY MEDICAL TRANSPORTATION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1043823602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCAR NON-EMERGENCY MEDICAL TRANSPORTATION, LLC

Provider Business Mailing Address
First Line	:	531 UPPER TERRACE DR
Second Line	:
City	:	INDEPENDENCE
State	:	IA
Zip	:	50644-3100
Country	:	US
Telephone Number	:	319-961-2311
Fax Number	:

Provider Business Practice Location Address
First Line	:	531 UPPER TERRACE DR
Second Line	:
City	:	INDEPENDENCE
State	:	IA
Zip	:	50644-3100
Country	:	US
Telephone Number	:	319-961-2311
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CHARLES ADILIKE
Credential	:
Telephone Number	:	319-961-2311

Provider Enumeration Date	:	08/24/2020
Last Update Date	:	08/24/2020

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