MEDICARE: CARE 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	:	1932863016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE TRANSPORT LLC

Provider Business Mailing Address
First Line	:	11601 AUDELIA RD APT 252
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-5652
Country	:	US
Telephone Number	:	682-559-3417
Fax Number	:

Provider Business Practice Location Address
First Line	:	11601 AUDELIA RD APT 252
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-5652
Country	:	US
Telephone Number	:	682-559-3417
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BERENICE SACRAMENTO
Credential	:
Telephone Number	:	682-559-3417

Provider Enumeration Date	:	10/26/2021
Last Update Date	:	10/26/2021

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Directions to “CARE TRANSPORT LLC ” Practice Location

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