Healthcare Provider Details

I. General information

NPI: 1215646633
Provider Name (Legal Business Name): BUNA TRANSPORTATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2022
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11601 BARROWS RIDGE LN
CHESTERFIELD VA
23838-5331
US

IV. Provider business mailing address

11601 BARROWS RIDGE LN
CHESTERFIELD VA
23838-5331
US

V. Phone/Fax

Practice location:
  • Phone: 540-287-1545
  • Fax:
Mailing address:
  • Phone: 540-287-1545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: MR. TYLER DEMETRIUS PARKER
Title or Position: OWNER/PARTNER
Credential: MS, MBA
Phone: 540-287-1545