Provider Demographics
NPI:1376352088
Name:CARE DRIVE NEMT LLC
Entity type:Organization
Organization Name:CARE DRIVE NEMT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KELVIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BLACKMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:702-981-1310
Mailing Address - Street 1:1712 CRYSTAL DOWNS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2413
Mailing Address - Country:US
Mailing Address - Phone:702-569-5932
Mailing Address - Fax:
Practice Address - Street 1:1712 CRYSTAL DOWNS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2413
Practice Address - Country:US
Practice Address - Phone:702-708-5875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)