MEDICARE: WECARE MEDICAL 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	:	1669718011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WECARE MEDICAL TRANSPORT, LLC

Provider Business Mailing Address
First Line	:	1520 STONEMOSS CT
Second Line	:	SUITE 101
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-5731
Country	:	US
Telephone Number	:	757-226-0803
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 STONEMOSS CT
Second Line	:	SUITE 101
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-5731
Country	:	US
Telephone Number	:	757-226-0803
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. JEMMALYN ANONUEVO HEWLETT
Credential	:
Telephone Number	:	757-226-0803

Provider Enumeration Date	:	12/12/2012
Last Update Date	:	12/12/2012

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