Healthcare Provider Details

I. General information

NPI: 1255919783
Provider Name (Legal Business Name): DIANES TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 PLANK RD
LAWRENCEVILLE VA
23868-1719
US

IV. Provider business mailing address

416 PLANK RD
LAWRENCEVILLE VA
23868-1719
US

V. Phone/Fax

Practice location:
  • Phone: 434-378-0879
  • Fax:
Mailing address:
  • Phone: 434-378-0879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: KENTTICA HOPSON
Title or Position: OWNER
Credential:
Phone: 434-378-0879