Healthcare Provider Details

I. General information

NPI: 1689394587
Provider Name (Legal Business Name): C2C MED TRANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3118 CASTLEBURY DR
CHESTER VA
23831-1853
US

IV. Provider business mailing address

3118 CASTLEBURY DR
CHESTER VA
23831-1853
US

V. Phone/Fax

Practice location:
  • Phone: 804-867-6337
  • Fax:
Mailing address:
  • Phone: 804-867-6337
  • 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: MARIA MUNIZ ESPANA
Title or Position: OWNER
Credential:
Phone: 804-715-7225