MEDICARE: AKC TRANSPORTATION SERVICES, 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	:	1659917490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKC TRANSPORTATION SERVICES, LLC

Provider Business Mailing Address
First Line	:	6621 SOUTHPOINT DR N STE 120
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6189
Country	:	US
Telephone Number	:	904-683-8666
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 ARMSDALE RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-3048
Country	:	US
Telephone Number	:	904-683-8666
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATION/OWNER
Name	:	MS. CARRIE A MOON
Credential	:
Telephone Number	:	904-683-8666

Provider Enumeration Date	:	11/26/2019
Last Update Date	:	11/26/2019

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