Provider Demographics
NPI:1245714450
Name:SAFE CARE TRANSPORTATION LLC
Entity type:Organization
Organization Name:SAFE CARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EVERTON
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:315-491-4693
Mailing Address - Street 1:118 BERGER AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13205-1704
Mailing Address - Country:US
Mailing Address - Phone:315-491-4693
Mailing Address - Fax:315-991-4626
Practice Address - Street 1:118 BERGER AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205-1704
Practice Address - Country:US
Practice Address - Phone:315-491-4693
Practice Address - Fax:315-991-4626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04949464Medicaid