MEDICARE: ARCPATHWAYS TRANSPORTATION

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	:	1851118947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCPATHWAYS TRANSPORTATION

Provider Business Mailing Address
First Line	:	215 N MARENGO AVE PH 2501007
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-1503
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 N MARENGO AVE PH 2501007
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-1503
Country	:	US
Telephone Number	:	213-786-1230
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JACOVEN TATE
Credential	:
Telephone Number	:	909-380-9174

Provider Enumeration Date	:	09/20/2024
Last Update Date	:	09/20/2024

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Directions to “ARCPATHWAYS TRANSPORTATION ” Practice Location

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