Healthcare Provider Details

I. General information

NPI: 1467369447
Provider Name (Legal Business Name): LIGHTHOUSE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14233 NC HIGHWAY 125
HALIFAX NC
27839-8773
US

IV. Provider business mailing address

14233 NC HIGHWAY 125
HALIFAX NC
27839-8773
US

V. Phone/Fax

Practice location:
  • Phone: 434-378-8561
  • Fax: 804-988-5254
Mailing address:
  • Phone: 434-378-8561
  • Fax: 804-988-5254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JESSICA ASHLEY
Title or Position: CEO
Credential:
Phone: 434-378-8561