MEDICARE: CARE GO 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	:	1669226114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE GO LLC

Provider Business Mailing Address
First Line	:	1001 NAVAHO DR STE 209
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7368
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 NAVAHO DR STE 209
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7368
Country	:	US
Telephone Number	:	919-760-5182
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	SAMUEL MWAURA
Credential	:
Telephone Number	:	919-760-5182

Provider Enumeration Date	:	04/12/2024
Last Update Date	:	04/19/2024

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