Provider Demographics
NPI:1609753300
Name:PROCARE TRANSPORTATION LLC
Entity type:Organization
Organization Name:PROCARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEM
Authorized Official - Middle Name:
Authorized Official - Last Name:DESTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-529-7356
Mailing Address - Street 1:1396 CLAY ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-1947
Mailing Address - Country:US
Mailing Address - Phone:651-529-7356
Mailing Address - Fax:503-506-0620
Practice Address - Street 1:1396 CLAY ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1947
Practice Address - Country:US
Practice Address - Phone:651-529-7356
Practice Address - Fax:503-506-0620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi