MEDICARE: FOREVER MOBILE 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	:	1427832344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREVER MOBILE LLC

Provider Business Mailing Address
First Line	:	5611 NW 86TH AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2870
Country	:	US
Telephone Number	:	954-709-6570
Fax Number	:

Provider Business Practice Location Address
First Line	:	5611 NW 86TH AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2870
Country	:	US
Telephone Number	:	954-709-6570
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. KAMAR EBANKS
Credential	:
Telephone Number	:	954-709-6570

Provider Enumeration Date	:	08/22/2023
Last Update Date	:	08/22/2023

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Directions to “FOREVER MOBILE LLC ” Practice Location

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