Healthcare Provider Details

I. General information

NPI: 1578088944
Provider Name (Legal Business Name): MEDIX TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 PIGG RIVER RD
GLADE HILL VA
24092-4048
US

IV. Provider business mailing address

247 PIGG RIVER RD
GLADE HILL VA
24092-4048
US

V. Phone/Fax

Practice location:
  • Phone: 540-493-4848
  • Fax:
Mailing address:
  • Phone: 540-493-4848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN BISHOP
Title or Position: OWNER
Credential:
Phone: 540-493-4848