Provider Demographics
NPI:1114448248
Name:S.M.A.R.T. CARE TRANSPORTATION, LLC.
Entity Type:Organization
Organization Name:S.M.A.R.T. CARE TRANSPORTATION, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:
Authorized Official - Last Name:RYCRAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-388-2869
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-0071
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17847 BRETZ DR
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1954
Practice Address - Country:US
Practice Address - Phone:312-388-2869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)