Healthcare Provider Details

I. General information

NPI: 1245454792
Provider Name (Legal Business Name): MINUTEMAN TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9208 HONEY CREEPER CT
BURKE VA
22015-3326
US

IV. Provider business mailing address

9208 HONEY CREEPER CT
BURKE VA
22015-3326
US

V. Phone/Fax

Practice location:
  • Phone: 703-459-0922
  • Fax: 703-992-0234
Mailing address:
  • Phone: 703-459-0922
  • Fax: 703-992-0234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number482
License Number StateDC

VIII. Authorized Official

Name: MR. WILLIAM AYENSON
Title or Position: PRESIDENT
Credential:
Phone: 301-585-5830