MEDICARE: RE-ASSURE NON EMERGENCY 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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871127423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RE-ASSURE NON EMERGENCY TRANSPORTATION

Provider Business Mailing Address
First Line	:	333 SE CORK RD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34984-6305
Country	:	US
Telephone Number	:	561-398-4810
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 SE CORK RD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34984-6305
Country	:	US
Telephone Number	:	561-398-4810
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PAUL P POTEAU
Credential	:
Telephone Number	:	561-398-4810

Provider Enumeration Date	:	02/22/2020
Last Update Date	:	03/06/2020

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