Provider Demographics
NPI:1356095145
Name:ASSURANCE CARE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:ASSURANCE CARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REKENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-712-7774
Mailing Address - Street 1:1409 WASHINGTON AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-1917
Mailing Address - Country:US
Mailing Address - Phone:314-733-5420
Mailing Address - Fax:314-733-5421
Practice Address - Street 1:1409 WASHINGTON AVE STE 410
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1917
Practice Address - Country:US
Practice Address - Phone:314-733-5420
Practice Address - Fax:314-733-5421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOLC014354939OtherCHARTER NUMBER