Provider Demographics
NPI:1992441141
Name:CARETRUST TRANSPORT, LLC
Entity type:Organization
Organization Name:CARETRUST TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARIAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SESAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-762-6833
Mailing Address - Street 1:13408 CLASSIC CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13408 CLASSIC CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4502
Practice Address - Country:US
Practice Address - Phone:571-762-6833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)