Healthcare Provider Details

I. General information

NPI: 1366810202
Provider Name (Legal Business Name): SEWARDS MEDICAL TRANSPORTATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 09/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 TRAVIS DR
LAWRENCEVILLE VA
23868-4025
US

IV. Provider business mailing address

218 TRAVIS DR
LAWRENCEVILLE VA
23868-4025
US

V. Phone/Fax

Practice location:
  • Phone: 434-848-2807
  • Fax: 434-848-2807
Mailing address:
  • Phone: 434-848-2807
  • Fax: 434-848-2807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MALIQUE ANTONIO SEWARD
Title or Position: PRESIDENT
Credential:
Phone: 434-848-2807