Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with ModivCare (formerly LogistiCare) before sending sensitive documents. FaxFlow is not affiliated with this organization.
ModivCare (formerly LogistiCare) fax number
(877) 835-7432
Facility Department
Used for: Submission of Medical Necessity Form (MNF) for Medicaid Non-Emergency Transportation (NEMT); used to justify transport for medically necessary services.
Fax destination details
- Department
- Facility Department
- Purpose
- Submission of Medical Necessity Form (MNF) for Medicaid Non-Emergency Transportation (NEMT); used to justify transport for medically necessary services.
- Form
- Medical Necessity Form — Medical Necessity Form (MNF)
- Address
- ModivCare Corporate Headquarters, 6900 Layton Avenue, Suite 1200, Denver, CO 80237, USA
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Form must be completed by a licensed physician/physician assistant/nurse practitioner, with patient name, DOB, Medicaid ID, destination, and service level; submit to ModivCare's Facility Department via secure fax; incomplete forms will be rejected.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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No public source link was saved with this record. Confirm the number directly with the organization before using it.