MEDICARE: COVED TRANSPORT 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	:	1881080075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COVED TRANSPORT LLC

Provider Business Mailing Address
First Line	:	4415 MCKINLEY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-1835
Country	:	US
Telephone Number	:	281-857-2015
Fax Number	:

Provider Business Practice Location Address
First Line	:	3707 WESTCENTER DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-5239
Country	:	US
Telephone Number	:	281-857-2015
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. COREY DEVILLE CARROLL
Credential	:
Telephone Number	:	832-503-9465

Provider Enumeration Date	:	04/14/2015
Last Update Date	:	04/14/2015

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Directions to “COVED TRANSPORT LLC ” Practice Location

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