Provider Demographics
NPI:1669823449
Name:PROCARE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:PROCARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WINNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:IRUNGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-200-7021
Mailing Address - Street 1:I BALLARD WAY
Mailing Address - Street 2:STE 101
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1070
Mailing Address - Country:US
Mailing Address - Phone:857-200-7021
Mailing Address - Fax:
Practice Address - Street 1:I BALLARD WAY
Practice Address - Street 2:STE 101
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1070
Practice Address - Country:US
Practice Address - Phone:857-200-7021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)