Omnicare Transport LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

OMNICARE TRANSPORT LLC

Practice address

1137 Taylor LN
Lewisville, TX 75077-2570

Phone

(972) 834-1507

Fax

(972) 590-2192

NPI assigned

Oct 31, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mwana Ndombe Ifulu

Title

Managing Partner

Phone

(972) 834-1507

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509408000000",
    "number": "1912419987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 TAYLOR LN",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750772570",
            "telephone_number": "972-834-1507",
            "fax_number": "972-590-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 TAYLOR LN",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750772570",
            "telephone_number": "972-834-1507",
            "fax_number": "972-590-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNICARE TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-31",
        "last_updated": "2017-10-31",
        "status": "A",
        "authorized_official_last_name": "IFULU",
        "authorized_official_first_name": "MWANA",
        "authorized_official_middle_name": "NDOMBE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "972-834-1507"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Non-emergency Medical Transport (VAN) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.