Healthcare Provider Details

I. General information

NPI: 1679306419
Provider Name (Legal Business Name): SUPER E TRANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 ENGLAND DR APT D
HENRICO VA
23229-4427
US

IV. Provider business mailing address

8401 MAYLAND DR STE S
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 804-603-1909
  • Fax:
Mailing address:
  • Phone: 804-603-1909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: LOFUL ELYARDO
Title or Position: CEO/OPERATIONS MANAGER
Credential:
Phone: 804-603-1909