Provider Demographics
NPI:1801371497
Name:ICARE TRANSPORTATION LLC
Entity type:Organization
Organization Name:ICARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVELYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GACII
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-727-8682
Mailing Address - Street 1:21526 W 98TH TER
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66220-2687
Mailing Address - Country:US
Mailing Address - Phone:785-727-8682
Mailing Address - Fax:
Practice Address - Street 1:21526 W 98TH TER
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66220-2687
Practice Address - Country:US
Practice Address - Phone:785-727-8682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201179100AMedicaid