Healthcare Provider Details

I. General information

NPI: 1942887310
Provider Name (Legal Business Name): HAZELS TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 06/29/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 TOWNE CENTRE BLVD UNIT 910
ANNAPOLIS MD
21401-2771
US

IV. Provider business mailing address

1125 WEST ST STE 200
ANNAPOLIS MD
21401-4279
US

V. Phone/Fax

Practice location:
  • Phone: 301-346-1911
  • Fax:
Mailing address:
  • Phone: 301-346-1911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: BRIAN A MCDONALD
Title or Position: CEO
Credential:
Phone: 443-493-7521