MEDICARE: CG MOBILITY 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	:	1710812540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CG MOBILITY LLC

Provider Business Mailing Address
First Line	:	2920 W BROAD ST # 32
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-5103
Country	:	US
Telephone Number	:	844-809-2646
Fax Number	:	833-681-3202

Provider Business Practice Location Address
First Line	:	2920 W BROAD ST # 32
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-5103
Country	:	US
Telephone Number	:	844-809-2646
Fax Number	:	833-681-3202

Authorized Official
Title or Position	:	ADMINISTRATION MANAGER
Name	:	MARLON MEREDITH
Credential	:
Telephone Number	:	307-752-9490

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/25/2026

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