Organization
PERSONAL CARE AMBULANCE TRANSPORT, LLC
Active
Other names
PCAT
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COLEY R. BEVINGTON (ADMINISTRATOR)
(765) 453-6307
Entity
Organization
Contact information
Practice address
216 CORWIN LN, KOKOMO, IN 46902-6612
(765) 453-6307
(765) 453-6382
Mailing address
216 CORWIN LN, KOKOMO, IN 46902-6612
(765) 453-6307
(765) 453-6382
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0849
IN
343900000X
Non-emergency Medical Transport (VAN)
0849
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340627
ANTHEM
IN
05
—
200491400A
—
IN
Enumeration date
12/01/2005
Last updated
12/08/2014
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