Provider Demographics
NPI:1184754285
Name:MEDCARE TRANSPORT INC
Entity type:Organization
Organization Name:MEDCARE TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VON ITTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-466-9939
Mailing Address - Street 1:2205 HIGHWAY 81
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-4332
Mailing Address - Country:US
Mailing Address - Phone:770-466-9939
Mailing Address - Fax:770-466-9949
Practice Address - Street 1:2205 HIGHWAY 81
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-4332
Practice Address - Country:US
Practice Address - Phone:770-466-9939
Practice Address - Fax:770-466-9949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA139663343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)