Healthcare Provider Details

I. General information

NPI: 1083090930
Provider Name (Legal Business Name): ARK TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28319 SOUTHAMPTON PKWY SUITE F
COURTLAND VA
23837-2193
US

IV. Provider business mailing address

28319 SOUTHAMPTON PKWY SUITE F
COURTLAND VA
23837-2193
US

V. Phone/Fax

Practice location:
  • Phone: 757-742-6097
  • Fax: 757-742-6098
Mailing address:
  • Phone: 757-742-6097
  • Fax: 757-742-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATRICIA EDMONIA HOLLAND
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 757-742-6097