Healthcare Provider Details

I. General information

NPI: 1245782192
Provider Name (Legal Business Name): ACCOMMODATING BRILLIANT CARING TRAVELS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2016
Last Update Date: 10/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021B CUNNINGHAM DR SUITE 2
HAMPTON VA
23666-3326
US

IV. Provider business mailing address

2021B CUNNINGHAM DR SUITE 2
HAMPTON VA
23666-3326
US

V. Phone/Fax

Practice location:
  • Phone: 215-431-8574
  • Fax: 757-262-2070
Mailing address:
  • Phone: 215-431-8574
  • Fax: 757-262-2070

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 Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: AZEEM SMITHSON
Title or Position: OWNER
Credential:
Phone: 215-431-8574