Healthcare Provider Details

I. General information

NPI: 1457733255
Provider Name (Legal Business Name): HEART SONG CARE TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 THIMBLE SHOALS BLVD SUITE 540
NEWPORT NEWS VA
23606-2573
US

IV. Provider business mailing address

610 THIMBLE SHOALS BLVD SUITE 540
NEWPORT NEWS VA
23606-2573
US

V. Phone/Fax

Practice location:
  • Phone: 757-877-4597
  • Fax:
Mailing address:
  • Phone: 757-877-4597
  • Fax:

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
# 3
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: RYAN DOUGLAS MILLER
Title or Position: CEO
Credential:
Phone: 757-877-4597