MEDICARE: CHILDS FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	45	VA

General Provider Information

NPI Number	:	1932623303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDS FOUNDATION

Provider Business Mailing Address
First Line	:	440 MONTICELLO AVE STE 1800
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-2670
Country	:	US
Telephone Number	:	757-955-8529
Fax Number	:	704-765-2644

Provider Business Practice Location Address
First Line	:	440 MONTICELLO AVE STE 1800
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-2670
Country	:	US
Telephone Number	:	757-955-8529
Fax Number	:	757-955-8529

Authorized Official
Title or Position	:	CEO
Name	:	MS. KIANA CHILDS
Credential	:
Telephone Number	:	757-541-0803

Provider Enumeration Date	:	07/27/2017
Last Update Date	:	07/27/2017

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Directions to “CHILDS FOUNDATION ” Practice Location

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