Healthcare Provider Details

I. General information

NPI: 1902768773
Provider Name (Legal Business Name): MEDEASE MEDICAL TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5021 CAPE MAY LOOP
CHESAPEAKE VA
23321-1444
US

IV. Provider business mailing address

5021 CAPE MAY LOOP
CHESAPEAKE VA
23321-1444
US

V. Phone/Fax

Practice location:
  • Phone: 757-510-3306
  • Fax:
Mailing address:
  • Phone: 757-510-3306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: MR. STANLEY LEE MYRICK JR.
Title or Position: OWNER
Credential:
Phone: 757-510-3306