MEDICARE: ADVANCED CARE TRANSPORTATION OF MARYLAND 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	:	1134930837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED CARE TRANSPORTATION OF MARYLAND LLC

Provider Business Mailing Address
First Line	:	4061 POWDER MILL RD # 105-7
Second Line	:
City	:	BELTSVILLE
State	:	MD
Zip	:	20705-3149
Country	:	US
Telephone Number	:	904-539-8469
Fax Number	:

Provider Business Practice Location Address
First Line	:	4061 POWDER MILL RD # 105-7
Second Line	:
City	:	BELTSVILLE
State	:	MD
Zip	:	20705-3149
Country	:	US
Telephone Number	:	904-539-8469
Fax Number	:

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	ROLANDO DUMAGAN
Credential	:
Telephone Number	:	904-539-8469

Provider Enumeration Date	:	01/14/2025
Last Update Date	:	01/14/2025

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