Provider Demographics
NPI:1306142286
Name:MIRACARE TRANSPORTATION SERVICES LLC
Entity type:Organization
Organization Name:MIRACARE TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARKOH
Authorized Official - Suffix:
Authorized Official - Credentials:FOUNDER
Authorized Official - Phone:704-890-6041
Mailing Address - Street 1:7101 CROSSRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-2217
Mailing Address - Country:US
Mailing Address - Phone:704-890-6041
Mailing Address - Fax:
Practice Address - Street 1:7101 CROSSRIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-2217
Practice Address - Country:US
Practice Address - Phone:704-890-6041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)