MEDICARE: SANDRA'S CAR SERVICE 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	:	1811453590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDRA'S CAR SERVICE LLC

Provider Business Mailing Address
First Line	:	2048 MCKINLEY ST. BAY #1
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020
Country	:	US
Telephone Number	:	954-851-3340
Fax Number	:

Provider Business Practice Location Address
First Line	:	2048 MCKINLEY ST. BAY #1
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020
Country	:	US
Telephone Number	:	954-851-3340
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. ANDREW BROWN
Credential	:
Telephone Number	:	954-851-3340

Provider Enumeration Date	:	02/18/2019
Last Update Date	:	05/09/2019

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