MEDICARE: ALL CARE TRANSPORT 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	:	1376912428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL CARE TRANSPORT LLC

Provider Business Mailing Address
First Line	:	5652 STRAWBERRY LAKES CIR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-6504
Country	:	US
Telephone Number	:	561-281-3190
Fax Number	:

Provider Business Practice Location Address
First Line	:	5652 STRAWBERRY LAKES CIRCLE
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463
Country	:	US
Telephone Number	:	561-281-3190
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MONIQUE THOMPSON
Credential	:
Telephone Number	:	561-281-3190

Provider Enumeration Date	:	09/18/2015
Last Update Date	:	09/18/2015

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