MEDICARE: CARIBBEAN IRIE 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	:	1194261503
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARIBBEAN IRIE LLC

Provider Business Mailing Address
First Line	:	6710 PRESCOTT DM
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78233-5481
Country	:	US
Telephone Number	:	210-277-9615
Fax Number	:

Provider Business Practice Location Address
First Line	:	6710 PRESCOTT DM
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78233-5481
Country	:	US
Telephone Number	:	210-277-9615
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANTHONY BROWN SR.
Credential	:
Telephone Number	:	210-277-9615

Provider Enumeration Date	:	01/09/2017
Last Update Date	:	01/09/2017

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Directions to “CARIBBEAN IRIE LLC ” Practice Location

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