MEDICARE: EN ROUTE TRANSIT 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	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1568145977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EN ROUTE TRANSIT LLC

Provider Business Mailing Address
First Line	:	14410 BALD EAGLE LN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-4634
Country	:	US
Telephone Number	:	757-230-0256
Fax Number	:

Provider Business Practice Location Address
First Line	:	14410 BALD EAGLE LN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-4634
Country	:	US
Telephone Number	:	757-230-0256
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	MR. JAMAINE JOHNSON
Credential	:
Telephone Number	:	757-230-0256

Provider Enumeration Date	:	08/11/2023
Last Update Date	:	08/11/2023

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Directions to “EN ROUTE TRANSIT LLC ” Practice Location

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