Provider Demographics
NPI:1841770435
Name:CAREMOBILE TRANSPORTATION, LLC.
Entity Type:Organization
Organization Name:CAREMOBILE TRANSPORTATION, LLC.
Other - Org Name:CAREMOBILE TRANSPORTATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-342-7827
Mailing Address - Street 1:6601 LITTLE RIVER TPKE STE 240
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-1316
Mailing Address - Country:US
Mailing Address - Phone:703-342-7827
Mailing Address - Fax:844-273-8478
Practice Address - Street 1:6601 LITTLE RIVER TPKE STE 240
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-1316
Practice Address - Country:US
Practice Address - Phone:703-342-7827
Practice Address - Fax:844-273-8478
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRE HOME CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1275022295Medicaid