MEDICARE: CAREONE TRANSPORT SYSTEMS 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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	B-2029	OTHER	NE	PROVIDER NUMBER

General Provider Information

NPI Number	:	1295480622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREONE TRANSPORT SYSTEMS LLC

Provider Business Mailing Address
First Line	:	3033 N 93RD ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-4715
Country	:	US
Telephone Number	:	531-210-0832
Fax Number	:	402-206-2388

Provider Business Practice Location Address
First Line	:	3033 N 93RD ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-4715
Country	:	US
Telephone Number	:	531-210-0832
Fax Number	:	402-206-2388

Authorized Official
Title or Position	:	DIRECTOR
Name	:	WATSON CHIPAKO
Credential	:
Telephone Number	:	402-504-3219

Provider Enumeration Date	:	02/14/2022
Last Update Date	:	02/14/2022

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