MEDICARE: PLATTS CASE MANAGEMENT SERVIES

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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1215170063	OTHER	NC	NPI

General Provider Information

NPI Number	:	1720457393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLATTS CASE MANAGEMENT SERVIES

Provider Business Mailing Address
First Line	:	11409 TURN STONE CT
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3997
Country	:	US
Telephone Number	:	704-340-0908
Fax Number	:

Provider Business Practice Location Address
First Line	:	11409 TURN STONE CT
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3997
Country	:	US
Telephone Number	:	704-340-0908
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. MIRANDA RENEE' PLATT
Credential	:
Telephone Number	:	704-340-0908

Provider Enumeration Date	:	09/24/2015
Last Update Date	:	09/24/2015

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