Provider Demographics
NPI:1790535771
Name:REGIONAL CARE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:REGIONAL CARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZATION/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANNELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-235-7183
Mailing Address - Street 1:3857 ROBENA RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-7582
Mailing Address - Country:US
Mailing Address - Phone:904-235-7183
Mailing Address - Fax:
Practice Address - Street 1:3857 ROBENA RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-7582
Practice Address - Country:US
Practice Address - Phone:904-235-7183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)