Provider Demographics
NPI:1992387997
Name:CARE TRANSPORT SERVICE LLC
Entity Type:Organization
Organization Name:CARE TRANSPORT SERVICE LLC
Other - Org Name:CARE TRANSPORT SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCKBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-344-8900
Mailing Address - Street 1:931 MADISON AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6995
Mailing Address - Country:US
Mailing Address - Phone:507-344-8900
Mailing Address - Fax:
Practice Address - Street 1:931 MADISON AVE STE 203
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6995
Practice Address - Country:US
Practice Address - Phone:507-344-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA668693400OtherUMPI